NPIMap

Individual provider Active NPI

Michael Luo, MD

  • Diagnostic Radiology Physician
  • Hackensack, NJ
National Provider Identifier
1760801286
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA10745200 Issued in NJ
Practice address
30 Prospect Ave
Radiology Dept
Hackensack, NJ 07601-1915
Phone
(000) 000-0000
NPI assigned
Apr 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA10745200 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Radiology Dept
Hackensack, NJ 07601-1915

Mailing address

130 Kinderkamack Rd Ste 200
River Edge, NJ 07661-1951
Phone (201) 488-2660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324000016 GA Practitioner - Diagnostic Radiology 8527499151 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Radiology Services P CGroup PAC ID 3577454024, 70 clinicians
Summit Imaging Services LLCGroup PAC ID 9436597945, 71 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

145 E Peacock St
Cochran, GA 31014-7846
Phone (478) 934-6211

Hospital & facility affiliations

  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
  • Piedmont Cartersville Medical Center Hospital, Cartersville, GA, CCN 110030
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.58 of 100Reported as group
Quality
85.31
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Imaging Center CurrentSince Jun 1, 2022 Accepting new patients
Summit Imaging Services LLC Diagnostic Radiology CurrentSince Mar 20, 2024 Accepting new patients
Summit Radiology Services P C Diagnostic Radiology CurrentSince May 1, 2022 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Tanner Medical Group Inc PastSince Jun 1, 2022 Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

706 Dixie St
Ste 100
Carrollton, GA 30117
Phone (770) 812-8614

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1760801286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD STE 200",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611951",
            "telephone_number": "201-488-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "RADIOLOGY DEPT",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-11",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA10745200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.