NPIMap

Organization Active NPI

Pueblo Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Santa Barbara, CA
National Provider Identifier
1871549899
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PUEBLO RADIOLOGY MEDICAL GROUP INC
Practice address
250 W Pueblo St
Santa Barbara, CA 93105-3805
Phone
(805) 682-7744
Fax
(805) 682-3321
NPI assigned
May 25, 2006
Last updated
May 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Lawrence Harter, MDNPI 1891749131
Title
President
Phone
(805) 682-7984

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)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

250 W Pueblo St
Santa Barbara, CA 93105-3805

Mailing address

Dept la 21613
Pasadena, CA 91185-1613
Phone (949) 263-8620

Other identifiers 11

IdentifierTypeStateIssuer
GR0011030MedicaidCA
ZZZ50521YOtherCABS
ZZZ73471ZMedicaidCA
GR0011035MedicaidCA
GR0011038MedicaidCA
GR001103CMedicaidCA
GR0011039MedicaidCA
GR0011037MedicaidCA
GR001103BMedicaidCA
GR001103AMedicaidCA
GR0011034MedicaidCA

National Provider Directory

National Provider Directory

Locations

355 Central Ave
Ste 218
Fillmore, CA 93015
Phone (805) 524-9000

828 W Ventura St
Ste 140
Fillmore, CA 93015
Phone (805) 524-9700

1600 N Rose Ave
Ste 110
Oxnard, CA 93030

Dept LA 21613
Pasadena, CA 91185

1525 State St
Ste 102
Santa Barbara, CA 93101
Phone (805) 560-8111

31 W Gutierrez St
Santa Barbara, CA 93101

315 Camino del Remedio
#3
Santa Barbara, CA 93110

31W Gutierrez St
Santa Barbara, CA 93101

3892 State St
Ste 110
Santa Barbara, CA 93105
Phone (805) 563-7600

1310 Las Tablas Rd
Ste 206
Templeton, CA 93465
Phone (805) 434-2900

168 N Brent St
Ste 401
Ventura, CA 93003
Phone (805) 652-5093

4155 Ferncreek Dr
Ste 201
Fayetteville, NC 28314
Phone (910) 484-8492

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 83

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 83

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1871549899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21613",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851613",
            "telephone_number": "949-263-8620",
            "fax_number": "949-263-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053805",
            "telephone_number": "805-682-7744",
            "fax_number": "805-682-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO RADIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "HARTER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-682-7984",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011030",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "ZZZ50521Y",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ73471Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011035",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011038",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR001103C",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011039",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011037",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR001103B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR001103A",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0011034",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.