X-Ray Professional Association
Organization Active NPI Diagnostic Radiology Physician · Concord, NH
NPI 1790758449 · NPPES record last updated Oct 18, 2007
Key facts
- NPI
- 1790758449
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- X-RAY PROFESSIONAL ASSOCIATION
- Practice address
- 2 1/2 Beacon St
Concord, NH 03301-4447 - Phone
- (603) 228-1521
- Fax
- (603) 225-2510
- NPI assigned
- Feb 10, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- X-RAY PROFESSIONAL ASSOCIATION
Authorized official
- Name
- Timothy J McCormack, MD
- Title
- Director
- Phone
- (603) 228-1521
Practitioners 97
-
Herlen Alencar, M.D.
-
Matthew H Dimasi, MD
-
David Andrew Glazier, M.D.
-
Steffen Haider, MD
-
Arie I Salis, M.D.
-
Jesse B Smith, MD
-
Joseph G Venus, M.D.
-
William Collins Wrobel, M.D.
-
Daniel Tyler Zapton, M.D.
-
Syed Akbar, MD
-
Matthew Weslee Allen, M.D.
-
Sandeep Amesur, M.D.
-
Daniel M Baker, M.D.
-
David K Bass, MD
-
Troy Allyn Belle, MD
-
Robert Berger, M.D.
-
Michael David Berven, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (27 enrollments) in NH, AZ, CA, OH, UT, MO, IL, MI, CO, TX, FL, ID, OR, GA, HI, NC, WA, SC, VA, PA, WI, KS, MA, DC, MD, NV, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040421000516 | NH | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 27 practitioners Practice locations: Franklin, NH; Wolfeboro, NH; Meredith, NH; Laconia, NH; Gilford, NH; Concord, NH; Amherst, NH |
| O20200717002592 | AZ | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 3 practitioners Practice locations: Chandler, AZ; Flagstaff, AZ; Paradise Valley, AZ |
| O20200721000816 | CA | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 3 practitioners Practice locations: Petaluma, CA; San Diego, CA; Livermore, CA; Huntington Beach, CA; Del Mar, CA; Chino Hills, CA; Chico, CA |
| O20200728000558 | OH | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 2 practitioners Practice locations: New Albany, OH |
| O20200729000896 | UT | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 4 practitioners Practice locations: Sandy, UT; St George, UT; Draper, UT |
| O20200729002086 | MO | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 2 practitioners Practice locations: Parkville, MO; Saint Louis, MO |
| O20200820002192 | IL | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Oak Brook, IL |
| O20200821001939 | MI | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 3 practitioners Practice locations: Grand Blanc, MI; Saline, MI; West Bloomfield, MI |
| O20200831001160 | CO | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 9 practitioners Practice locations: Colorado Springs, CO; Denver, CO; Parker, CO; Steamboat Springs, CO |
| O20200831001769 | TX | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 7 practitioners Practice locations: Coppell, TX; Dripping Springs, TX; Houston, TX; San Antonio, TX; Spicewood, TX; Sugar Land, TX |
| O20200902002713 | FL | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 5 practitioners Practice locations: Melbourne Beach, FL; North Miami Beach, FL; Palm City, FL; Sarasota, FL; Wellington, FL |
| O20200908003064 | ID | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Worley, ID |
| O20200914001514 | OR | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 2 practitioners Practice locations: La Grande, OR; Salem, OR |
| O20200915000485 | GA | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 2 practitioners Practice locations: Clayton, GA; Macon, GA |
| O20200915002517 | HI | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 2 practitioners Practice locations: Kailua, HI |
| O20200915003452 | NC | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Greensboro, NC |
| O20200915003477 | WA | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 3 practitioners Practice locations: Seattle, WA; Liberty Lake, WA; Bellevue, WA |
| O20200916002764 | SC | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Sullivans Island, SC |
| O20200917002142 | VA | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 4 practitioners Practice locations: Earlysville, VA; Glen Allen, VA; Leesburg, VA; Middleburg, VA; Virginia Beach, VA |
| O20200922002625 | PA | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 5 practitioners Practice locations: Venetia, PA; Paoli, PA; Huntingdon, PA; Haverford, PA |
| O20201001003461 | WI | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Beloit, WI |
| O20201222001497 | KS | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 4 practitioners Practice locations: Hays, KS; Overland Park, KS; Wichita, KS |
| O20210319001252 | MA | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 4 practitioners Practice locations: Lexington, MA; Newton, MA; North Andover, MA; Wellesley, MA; Weymouth, MA |
| O20230515002598 | DC | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Alexandria, VA |
| O20230516000035 | MD | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Clarksville, MD |
| O20240419003071 | NV | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Reno, NV |
| O20260326002625 | IN | Part B Supplier - Clinic/Group Practice | 3375539927 |
Receives reassigned benefits from 1 practitioner Practice locations: Indianapolis, IN |
National Provider Directory
- Part of
- X-Ray Professional Assoc
Locations
247 Pleasant St
Concord, NH 03301
Phone (603) 228-2101
248 Pleasant St
Ste 199
Concord, NH 03301
14 Maple St
Ste 200
Gilford, NH 03249
Phone (603) 524-2852
740 N Main St
Laconia, NH 03246
734 N Main St
Laconia, NH 03246
Phone (603) 527-1855
80 Highland St
Ste 199
Laconia, NH 03246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
2 1/2 Beacon St
Concord, NH 03301-4447
Mailing address
2 1/2 Beacon St
Concord, NH 03301-4447
Phone (603) 228-1521
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XRAY300249 | Other | NH | ANTHEM BCBS OF NH |
| 99000249 | Medicaid | NH | |
| CB4403 | Other | NH | RAILROAD MEDICARE |
Other providers in Concord, NH
- Ziwei Wu
- Jessica Wunderlich
- Bridget Wyatt
- Alyssa Wyman
- William J Wyman
- Yaqian Xu
- Cassie Yackley
- Courtney Yacovelli
- Amanda E C Yager
- Ronald L. Yap
All providers in Concord, NH · Diagnostic Radiology Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2007. 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.