NPIMap

Organization Active NPI

Methodist-Cdi

Doing business as RAYUS Radiology

  • Diagnostic Radiology Physician
  • Mansfield, TX
National Provider Identifier
1841742038
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
METHODIST-CDI
Doing business as
RAYUS Radiology
Practice address
2975 E Broad St Ste 101
Mansfield, TX 76063-9185
Phone
(214) 420-5445
Fax
(817) 453-8082
NPI assigned
Nov 4, 2016
Last updated
Jan 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Authorized official

Name
Susan C Holman
Title
Special Assistant Secretary
Phone
(952) 513-6831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

2975 E Broad St Ste 101
Mansfield, TX 76063-9185

Mailing address

5775 Wayzata Blvd
Suite 400
St Louis Park, MN 55416-1222

Other names 1

  • RAYUS Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150106001211 TX Part B Supplier - Clinic/Group Practice 3072836600 Receives reassigned benefits from 144 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Desoto, TX; Mansfield, TX; McKinney, TX; Plano, TX; Richardson, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2122853Methodist-Cdi Dba2975 E Broad St Suite 101, Mansfield, TX 76063Certificate of waiverDec 6, 2026

National Provider Directory

National Provider Directory
Tax ID family
Methodist-Cdi3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7300 Eldorado Pkwy
Ste 170
McKinney, TX 75070
Phone (972) 920-0150

5025 W Park Blvd
Ste 500
Plano, TX 75093
Phone (972) 596-1934

8080 Independence Pkwy
Ste 105
Plano, TX 75025
Phone (972) 208-1858

Practitioners & affiliated clinicians

Practitioners 131

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 131

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1841742038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "SUITE 400",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 E BROAD ST STE 101",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639185",
            "telephone_number": "214-420-5445",
            "fax_number": "817-453-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST-CDI",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SPECIAL ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "952-513-6831"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAYUS Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.