Active NPI
Medford Radiological Group PC
- Diagnostic Radiology Physician
- Brookings, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- MEDFORD RADIOLOGICAL GROUP PC
- Practice address
- 648 Chetco Ave
Brookings, OR 97415 - Phone
- (541) 412-2070
- NPI assigned
- Jul 15, 2010
- Last updated
- Jul 15, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Troychak, MD
- Title
- President
- Phone
- (541) 773-2493
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
648 Chetco Ave
Brookings, OR 97415
Mailing address
PO Box 2947
Unit 1001
Portland, OR 97208-2947
Phone (559) 455-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100604000059 | OR | Part B Supplier - Clinic/Group Practice | 2062303324 |
Receives reassigned benefits from 29 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Medford, OR; Bend, OR; North Bend, OR; Portland, OR; Salem, OR; Ashland, OR; Brookings, OR; Jacksonville, OR… |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Diagnostic Radiology Physician
- Roseburg, OR
- NPI 1285930545
O20100604000059
-
- Diagnostic Radiology Physician
- Bend, OR
- NPI 1659813392
O20100604000059
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1407938111
O20100604000059
National Provider Directory
National Provider DirectoryMember organizations 2
Organizations listed as members of this organization in the National Provider Directory.
-
- Magnetic Resonance Imaging Radiologic Technologist
- Medford, OR
- NPI 1083688402
Member Of
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Diagnostic Radiology Physician
- Medford, OR
- NPI 1841252913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1279152000000",
"number": "1841503109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2947",
"address_2": "UNIT 1001",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972082947",
"telephone_number": "559-455-4000",
"fax_number": "770-776-5992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "648 CHETCO AVE",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "97415",
"telephone_number": "541-412-2070"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDFORD RADIOLOGICAL GROUP PC",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-15",
"last_updated": "2010-07-15",
"status": "A",
"authorized_official_last_name": "TROYCHAK",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "541-773-2493",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.