Alerra, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

ALERRA, LLC

Doing business as

STATMOBILE HEALTHCARE
StatMobile
Synergy Mobile X-Ray

Practice address

32244 Paseo Adelanto Ste B
San Juan Capistrano, CA 92675-3617

Phone

(323) 559-9683

NPI assigned

Aug 28, 2018

Organization subpart

No

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

Authorized official

Name

Dustin Monroe

Title

General Counsel

Phone

(385) 240-6408

Specialties & licenses 4

Addresses

Other names 3

• STATMOBILE HEALTHCARE Doing business as
• StatMobile Doing business as
• Synergy Mobile X-Ray Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Portable X-ray supplier certification: CCN 05X0010060

Legal name

SYNERGY MOBILE RADIOLOGY

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Mar 27, 2020

Last certification

Mar 27, 2020

Ownership / control type

Corporation

Facility address

32244 Paseo Adelanto, Ste B
San Juan Capistrano, CA 92675

Tax ID family

Alerra LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Alerra, LLC

  • Mobile Radiology Clinic/Center
  • Portland, OR
  • NPI 1568927903
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Guy Elise Constant De Gent, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Whiteville, NC
  • NPI 1558323139
  NPD
• Richard Lance Dejournett, M.D.

  • Diagnostic Radiology Physician
  • Honolulu, HI
  • NPI 1982691341
  NPD

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676073600000",
    "number": "1780165662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32244 PASEO ADELANTO STE B",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753617",
            "telephone_number": "949-324-5808",
            "fax_number": "949-485-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32244 PASEO ADELANTO STE B",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753617",
            "telephone_number": "323-559-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALERRA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "385-240-6408"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STATMOBILE HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "StatMobile",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Synergy Mobile X-Ray",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.