Organization Active NPI

Radiological Associates of Sacramento Medical Group

  • Diagnostic Radiology Physician
  • Folsom, CA
National Provider Identifier
1831170851
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP
Practice address
1655 Creekside Dr
Folsom, CA 95630-3489
Phone
(916) 984-0739
Fax
(916) 983-3817
NPI assigned
Nov 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Dr. Jonathan Breslau, M.D.
Title
President
Phone
(916) 646-8300

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085B0100X CA
Neuroradiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0700X
Nuclear Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0904X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X CA Primary
Therapeutic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0203X
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X
Radiological Physics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0205X
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X CA

Addresses

Primary practice location

1655 Creekside Dr
Folsom, CA 95630-3489

Mailing address

1500 Expo Pkwy
Sacramento, CA 95815-4227
Phone (916) 646-8406

Other identifiers 1

IdentifierTypeStateIssuer
GR002851XMedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1831170851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EXPO PKWY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154227",
            "telephone_number": "916-646-8406",
            "fax_number": "916-920-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 CREEKSIDE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303489",
            "telephone_number": "916-984-0739",
            "fax_number": "916-983-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "BRESLAU",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-646-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiological Physics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR002851X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.