Advanced Imaging Diagnostics, PLLC
Organization Active NPI Diagnostic Radiology Physician · Salida, CO
NPI 1740991975 · NPPES record last updated Dec 8, 2022
Key facts
- NPI
- 1740991975
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- ADVANCED IMAGING DIAGNOSTICS, PLLC
- Practice address
- 1000 Rush Dr
Salida, CO 81201-9627 - Phone
- (719) 530-2200
- Fax
- (970) 667-0847
- NPI assigned
- Dec 8, 2022
- Organization subpart
- No
Authorized official
- Name
- Andrew McAdoo, DO
- Title
- Owner/Authorized Rep
- Phone
- (719) 238-0091
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Practitioners 10
-
Steven J Dileo, MD
-
Andrew McAdoo, DO
-
Abbas A Chamsuddin, M.D.
-
Marc Kaye, MD
-
Pradheep J Shanker, M.D.
-
Lloyd David Wagner, M.D.
-
Maximina Boutselis, M.D.
-
Michael Yuz, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (7 enrollments) in CO, MA, AZ, TX, CA, FL, OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230119001462 | CO | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 10 practitioners 1 other NPI on this enrollment Practice locations: Salida, CO; Westcliffe, CO |
| O20250227000228 | MA | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 1 practitioner Practice locations: Newburyport, MA |
| O20250304002062 | AZ | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 1 practitioner Practice locations: Cave Creek, AZ |
| O20250312002674 | TX | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 1 practitioner Practice locations: Colleyville, TX |
| O20250314000090 | CA | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 1 practitioner Practice locations: Santa Monica, CA |
| O20250314002639 | FL | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 2 practitioners Practice locations: Port St Lucie, FL |
| O20250403000390 | OH | Part B Supplier - Clinic/Group Practice | 6305217860 |
Receives reassigned benefits from 1 practitioner Practice locations: Dublin, OH |
National Provider Directory
- Tax ID family
- Advanced Imaging Diagnostics PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
1000 Rush Dr
Salida, CO 81201-9627
Mailing address
PO Box 7704
Loveland, CO 80537-0704
Phone (970) 663-2742
Other providers in Salida, CO
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All providers in Salida, CO · Diagnostic Radiology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.