Individual provider Active NPI

Maged S Tawadros

  • Radiography Radiologic Technologist
  • Pasadena, CA
National Provider Identifier
1871730937
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
RHF 76752 Issued in CA
Practice address
281 N Altadena Dr # F
Pasadena, CA 91107-3364
Phone
(626) 728-1708
Fax
(626) 294-9414
NPI assigned
Jan 12, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X RHF 76752 CA Primary

Addresses

Primary practice location

281 N Altadena Dr # F
Pasadena, CA 91107-3364

Mailing address

PO Box 1183
Temple City, CA 91780-1183
Phone (626) 728-1708

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090213000415 CA Part B Supplier - Portable X-Ray Supplier 7012072689 Practice locations: Temple City, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RHF 76752CAMDRadiography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
JT Imaging Mobile X-Ray CurrentSince Oct 31, 2021 Accepting new patients

Locations

11017 W Hondo Pkwy
Unit B
Temple City, CA 91780
Phone (626) 483-2632

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1871730937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1183",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801183",
            "telephone_number": "626-728-1708",
            "fax_number": "626-294-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 N ALTADENA DR # F",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073364",
            "telephone_number": "626-728-1708",
            "fax_number": "626-294-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWADROS",
        "first_name": "MAGED",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-12",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "RHF 76752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.