Organization Active NPI

Spectrum Imaging SC

  • Radiology Clinic/Center
  • Chicago, IL
National Provider Identifier
1821482621
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SPECTRUM IMAGING SC
Practice address
1638 W Surf St
Chicago, IL 60657-3599
Phone
(800) 695-8191
NPI assigned
Mar 19, 2015
Last updated
Mar 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Authorized official

Name
Dr. Gregory GoldsteinNPI 1821063496
Title
President
Phone
(800) 695-8191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1638 W Surf St
Chicago, IL 60657-3599

Mailing address

1638 W Surf St
Chicago, IL 60657-3599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH, MA, VA, OK, NJ, CA, AR, NY, PA, TX, OR, FL, NC, AZ, ME16 enrollments

Enrollment records 16

Enrollment IDStateProvider typePAC IDDetails
O20150501002011 IL Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 27 practitioners
Practice locations: Warrenville, IL; Chicago, IL
O20180824000730 OH Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, OH; Dublin, OH; Chagrin Falls, OH
O20191023001493 MA Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Boston, MA
O20201125001851 VA Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 3 practitioners
Practice locations: Keswick, VA; Rockingham, VA
O20210416001299 OK Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK
O20210817000127 NJ Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 2 practitioners
Practice locations: Delran, NJ; Moorestown, NJ
O20210924002005 CA Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 10 practitioners
Practice locations: Walnut, CA; Truckee, CA; Temecula, CA; San Francisco, CA; Palm Desert, CA; Los Angeles, CA; Moraga, CA; Glendale, CA…
O20220725002736 AR Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR
O20230512002465 NY Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 4 practitioners
Practice locations: West Nyack, NY; Rego Park, NY; Lagrangeville, NY; New York, NY; Hopewell Junction, NY; Middletown, NY; Hempstead, NY
O20230607000076 PA Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 4 practitioners
Practice locations: Ambler, PA; Hershey, PA; Philadelphia, PA; Red Lion, PA; Schnecksville, PA
O20241206003445 TX Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 3 practitioners
Practice locations: Austin, TX; College Station, TX; Houston, TX
O20250804001916 OR Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Oswego, OR
O20250827001626 FL Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 3 practitioners
Practice locations: Boca Raton, FL; Lake Mary, FL; Tampa, FL
O20260218002858 NC Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC
O20260302002637 AZ Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ
O20260330002408 ME Part B Supplier - Clinic/Group Practice 3678892247 Receives reassigned benefits from 1 practitioner
Practice locations: Bath, ME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1821482621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 W SURF ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 W SURF ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573599",
            "telephone_number": "800-695-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM IMAGING SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-695-8191",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.