Organization Active NPI

Monroeville Diagnostic Imaging Specialists LLC

  • Radiology Clinic/Center
  • Monroeville, PA
National Provider Identifier
1770622870
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MONROEVILLE DIAGNOSTIC IMAGING SPECIALISTS LLC
Practice address
3824 Northern Pike
Monroeville, PA 15146
Phone
(412) 373-6342
Fax
(412) 373-6347
NPI assigned
Feb 5, 2007
Last updated
Jan 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Dana Wardlow
Title
Practice Administrator
Phone
(724) 935-6280

Specialties & licenses 1

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

Addresses

Primary practice location

3824 Northern Pike
Monroeville, PA 15146

Mailing address

3824 Northern Pike
Suite 200
Monroeville, PA 15146
Phone (412) 457-0060

Other identifiers 5

IdentifierTypeStateIssuer
1012938680001MedicaidPA
001736377OtherHIGHMARK
1547029OtherGATEWAY
P00271297OtherRAILROAD MEDICARE
7593730OtherAETNA

National Provider Directory

National Provider Directory

Locations

3824 One Monroeville Ctr
Monroeville, PA 15146
Phone (412) 373-6342

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1770622870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "address_2": "SUITE 200",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "15146",
            "telephone_number": "412-457-0060",
            "fax_number": "412-457-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "15146",
            "telephone_number": "412-373-6342",
            "fax_number": "412-373-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROEVILLE DIAGNOSTIC IMAGING SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "WARDLOW",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "724-935-6280"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012938680001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "001736377",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1547029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00271297",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7593730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.