Individual provider Active NPI

Ivan G Murray, MD

  • Diagnostic Radiology Physician
  • Davenport, FL
National Provider Identifier
1801922786
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J2698 Issued in TX
Practice address
2235 North Blvd West
Davenport, FL 33837
Phone
(863) 421-8674
Fax
(863) 421-9622
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X J2698 TX Primary
Vascular & Interventional Radiology Physician 2085R0204X ME0053689 FL

Addresses

Primary practice location

2235 North Blvd West
Davenport, FL 33837

Mailing address

PO Box 2159
Haines City, FL 33845-2159
Phone (863) 421-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080313000336 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2860577947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Tulane University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Technological Radiology PAGroup PAC ID 8527043389, 7 clinicians

Practice addresses (Care Compare)

2235 N Blvd W
Davenport, FL 33837-8990
Phone (863) 421-9393

2235 N W Blvd
Davenport, FL 33837-8990
Phone (863) 421-9393

24040 US Hwy 27
Lake Wales, FL 33859-7813
Phone (863) 421-9393

315 Central Ave E
Winter Haven, FL 33880-3047
Phone (863) 421-9393

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J2698TXMDDiagnostic Radiology Physician
ME0053689FLMDVascular & Interventional Radiology Physician

Practice roles (3 of 5)

OrganizationSpecialtyStatusNew patients
Advance Technological Radiology, PA Diagnostic Radiology CurrentSince Sep 1, 1998 Accepting new patients
Florida Radiology Centers LLC Past Accepting new patients
Advance Technological Radiology, PA Diagnostic Radiology PastSince Aug 8, 2021 Accepting new patients

Locations

2235 North Blvd W
Davenport, FL 33837
Phone (863) 421-8674

315 E Central Ave
Winter Haven, FL 33880
Phone (863) 295-5674

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1801922786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2159",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338452159",
            "telephone_number": "863-421-9393",
            "fax_number": "863-421-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 NORTH BLVD WEST",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "863-421-8674",
            "fax_number": "863-421-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "IVAN",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J2698",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME0053689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.