NPIMap

Organization Active NPI

Biotech X-Ray, Inc.

  • Physiological Laboratory
  • Saint Louis, MO
National Provider Identifier
1790921088
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
000047082 Issued in MO
Legal business name
BIOTECH X-RAY, INC.
Practice address
1065 Executive Parkway Dr Ste 220
Saint Louis, MO 63141-6367
Phone
(314) 548-2900
Fax
(314) 548-2920
NPI assigned
Dec 17, 2008
Last updated
Aug 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BIOTECH X-RAY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Authorized official

Name
Mrs. Tamara Bishop Schwartz
Title
President
Phone
(314) 449-1669

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X 000047082 MO Primary
Physiological Laboratory 293D00000X 216464 IL

Addresses

Primary practice location

1065 Executive Parkway Dr Ste 220
Saint Louis, MO 63141-6367

Mailing address

1065 Executive Parkway Dr Ste 220
Saint Louis, MO 63141-6367
Phone (314) 548-2900

Other practice location 1

4709 E Dundas Ln
Dundas, IL 62425-2527
Phone (877) 909-9729

Other identifiers 2

IdentifierTypeStateIssuer
000047082OtherMOMEDICARE PTAN
216464OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080506000011 IL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6901792571 1 other NPI on this enrollment
Practice locations: Dundas, IL
O20080509000192 MO Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6901792571 1 other NPI on this enrollment
Practice locations: Saint Louis, MO
O20220221001424 WI Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6901792571 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oshkosh, WI

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Biotech Xray Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4709 E Dundas Ln
Dundas, IL 62425
Phone (314) 227-2700

1065 Executive Parkway Dr
Saint Louis, MO 63141

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1790921088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 EXECUTIVE PARKWAY DR STE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416367",
            "telephone_number": "314-548-2900",
            "fax_number": "314-548-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 EXECUTIVE PARKWAY DR STE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416367",
            "telephone_number": "314-548-2900",
            "fax_number": "314-548-2920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4709 E Dundas Ln",
            "address_purpose": "LOCATION",
            "city": "Dundas",
            "state": "IL",
            "postal_code": "624252527",
            "country_code": "US",
            "telephone_number": "877-909-9729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BIOTECH X-RAY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BIOTECH X-RAY, INC.",
        "enumeration_date": "2008-12-17",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "BISHOP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-449-1669",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "MO",
            "license": "000047082",
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "IL",
            "license": "216464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000047082",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "216464",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.