Psi Radiological Service, Inc

Primary specialty

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

License

24834 Issued in MI

Legal business name

PSI RADIOLOGICAL SERVICE, INC

Practice address

1320 Wilkins St
Detroit, MI 48207-4802

Phone

(313) 656-2151

Fax

(313) 656-2152

NPI assigned

Mar 8, 2006

Last updated

May 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Victor Collado, M.D., PHD

Title

Radiologist

Phone

(313) 962-2133

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

Practitioners 3

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.

• Joel P Kimelman, DO

  • Diagnostic Radiology Physician
  • Flint, MI
  • NPI 1720042674
  NPD (past)
• Craig Shepherd Smith, MD

  • Diagnostic Radiology Physician
  • Monroe, MI
  • NPI 1437242070
  NPD (past)
• Isaias S Villarosa, MD

  • Diagnostic Radiology Physician
  • Southfield, MI
  • NPI 1821046475
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1821066648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264324",
            "telephone_number": "313-962-2133",
            "fax_number": "313-962-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WILKINS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074802",
            "telephone_number": "313-656-2151",
            "fax_number": "313-656-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSI RADIOLOGICAL SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "COLLADO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "313-962-2133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "MI",
            "license": "24834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0E02504",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114483540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael F Prysak, MD
• Sean M. Prystash, M.D.
• Melissa Ann Przywara, OTR
• Psi Radiological Service Inc
• Psi Radiological Service Inc
• Psi Radiologist Group, PC
• Demetrious K Psimoulis, M.D.
• Psych MD PLLC
• Psychiatry and Behavioral Medicine Professionals (University Psychiatric Centers)
• Psychiatry and Behavioral Medicine Professionals (University Psychiatric Centers)

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Detroit, MI
• Providers in Detroit, MI by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.