NPIMap

Organization Active NPI

Omni Imaging, LLC

  • Diagnostic Radiology Physician
  • Everett, WA
National Provider Identifier
1871861591
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
603126999 Issued in WA
Legal business name
OMNI IMAGING, LLC
Practice address
3331 Broadway
Everett, WA 98201-4472
Phone
(425) 259-7900
Fax
(425) 252-0993
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Mr. Keyvan Yousefian
Title
Ceo
Phone
(425) 259-7900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X 603126999 WA Primary
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X 603126999 WA
Radiologic TechnologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 247100000X 603126999 WA
Sonography Radiologic TechnologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2471S1302X 603126999 WA

Addresses

Primary practice location

3331 Broadway
Everett, WA 98201-4472

Mailing address

3331 Broadway
Everett, WA 98201-4472
Phone (425) 259-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 50X0009834

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
OMNI IMAGING, LLC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
May 31, 2012
Last certification
May 31, 2012
Ownership / control type
CORPORATION
Facility address
3331 Broadway
Everett, WA 98201

National Provider Directory

National Provider Directory

Locations

3331 Broadway
Everett, WA 98201
Phone (425) 259-7900

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1871861591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014472",
            "telephone_number": "425-259-7900",
            "fax_number": "425-252-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014472",
            "telephone_number": "425-259-7900",
            "fax_number": "425-252-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "YOUSEFIAN",
        "authorized_official_first_name": "KEYVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-259-7900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "603126999",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "WA",
            "license": "603126999",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiologic Technologist",
            "state": "WA",
            "license": "603126999",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": "WA",
            "license": "603126999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.