Fastex Advanced Mobile Imaging

Primary specialty

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

License

RT00005601 Issued in WA

Legal business name

FASTEX ADVANCED MOBILE IMAGING

Practice address

411 N 18TH Avenue
Yakima, WA 98902

Phone

(509) 972-8617

NPI assigned

Feb 7, 2006

Organization subpart

No

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

Authorized official

Name

Michael Benitz, RTNPI 1669033601

Title

Owner

Phone

(509) 972-8617

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Portable X-ray supplier certification: CCN 50X0009828

Legal name

FASTEX ADVANCED MOBILE IMAGING

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Nov 16, 2004

Last certification

Oct 3, 2024

Ownership / control type

Corporation

Facility address

411 N 18TH Ave
Yakima, WA 98902

Tax ID family

Fastex Advanced Mobile Imaging2 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.

• Fastex Advanced Mobile Imaging

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Yakima, WA
  • NPI 1275535247
  NPD tax ID

Locations

Practitioners 4

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

• Michael Benitz

  • Radiologic Technologist
  • Yakima, WA
  • NPI 1669033601
  NPD Authorized official
• Joshua Jacobs

  • Radiologic Technologist
  • Yakima, WA
  • NPI 1588225528
  NPD (past)
• Shirley A Strader, LMP

  • Massage Therapist
  • Yakima, WA
  • NPI 1962743401
  NPD (past)
• Frederick Jarl Thysell, MD

  • General Practice Physician
  • Yakima, WA
  • NPI 1285643544
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1801869383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N 18TH AVENUE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-972-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N 18TH AVENUE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-972-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTEX ADVANCED MOBILE IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "BENITZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-972-8617",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "WA",
            "license": "RT00005601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7127954",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0195224",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Shawn Patrick Fay, PA-C
• Homira Feely, MSN, ARNP
• Jeffrey S Feen, PA

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Yakima, WA
• Providers in Yakima, WA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.