Northern California P.E.T. Imaging Center

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

Legal business name

NORTHERN CALIFORNIA P.E.T. IMAGING CENTER

Practice address

406 Sunrise Ave
Roseville, CA 95661-4106

Phone

(888) 738-3211

Fax

(916) 737-6203

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Bradley Schmidt

Title

Ceo

Phone

(916) 739-0788

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Northern California P.E.T. Imaging Center

  • Nuclear Medicine Physician
  • Rocklin, CA
  • NPI 1659069672

  9830156926

  Same PAC ID
• Northern California P.E.T. Imaging Center

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1992754741

  9830156926

  Same PAC ID

Tax ID family

Northern Ca Pet Imaging3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Northern California P.E.T. Imaging Center

  • Nuclear Medicine Physician
  • Rocklin, CA
  • NPI 1659069672
  NPD tax ID
• Northern California P.E.T. Imaging Center

  • Radiology Clinic/Center
  • Sacramento, CA
  • NPI 1992754741
  NPD tax ID

Practitioners 4

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

• Samuel L Kipper, M.D.

  • Nuclear Radiology Physician
  • Santa Ana, CA
  • NPI 1265498836
  NPD
• Dafang Wu, MD

  • Nuclear Medicine Physician
  • Sacramento, CA
  • NPI 1871553834
  NPD
• Tracy Lynnette Yarbrough, MD PHD

  • Nuclear Medicine Physician
  • Little Rock, AR
  • NPI 1275670358
  NPD
• Yamin Dou, M.D.

  • Nuclear Imaging & Therapy Physician
  • Burlington, MA
  • NPI 1568411320
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1790734317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165233",
            "telephone_number": "916-737-3211",
            "fax_number": "916-737-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614106",
            "telephone_number": "888-738-3211",
            "fax_number": "916-737-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA P.E.T. IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-739-0788"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northern California Fertility Medical Center
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• Northwoods Medical, LLC
• Charlie Eric Norwood Jr.
• Nicholas Noschese, PA-C
• Brandy E. Novak, M.S. LMFT
• Jacob Adam Novick, PA-C

• Nuclear Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Nuclear Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.