NPIMap

Organization Active NPI

Cyrus Diagnostic Imaging, Inc

  • Radiology Clinic/Center
  • Lake Mary, FL
National Provider Identifier
1740546357
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
ME30781 Issued in FL
Legal business name
CYRUS DIAGNOSTIC IMAGING, INC
Practice address
165 Waymont CT
Lake Mary, FL 32746-6093
Phone
(407) 321-3012
Fax
(407) 321-9006
NPI assigned
Apr 9, 2012
Last updated
Apr 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Masoud Vahdatpour, MBA; BS (RT)), RDMS
Title
Admin
Phone
(407) 321-3012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X ME30781 FL Primary

Addresses

Primary practice location

165 Waymont CT
Lake Mary, FL 32746-6093

Mailing address

165 Waymont CT
Lake Mary, FL 32746-6093
Phone (407) 321-3012

Other identifiers 1

IdentifierTypeStateIssuer
030234100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740546357. Details of each certification follow.

Portable X-ray supplier certification: CCN 10X0009922

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CYRUS DIAGNOSTIC IMAGING INC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Jul 30, 1999
Last certification
Mar 22, 2021
Ownership / control type
Corporation
Facility address
165 Waymont Court
Lake Mary, FL 32746

National Provider Directory

National Provider Directory

Locations

165 Waymont Ct
Lake Mary, FL 32746
Phone (407) 321-3012

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1740546357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 WAYMONT CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466093",
            "telephone_number": "407-321-3012",
            "fax_number": "407-321-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WAYMONT CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466093",
            "telephone_number": "407-321-3012",
            "fax_number": "407-321-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYRUS DIAGNOSTIC IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "VAHDATPOUR",
        "authorized_official_first_name": "MASOUD",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "407-321-3012",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA; BS (RT)), RDMS"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "FL",
            "license": "ME30781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030234100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.