NPIMap

Organization Active NPI

All-Stat Portable Mi LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Saint Joseph, MI
National Provider Identifier
1881342863
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
ALL-STAT PORTABLE MI LLC
Practice address
515 Ship St Ste 209
Saint Joseph, MI 49085-1155
Phone
(224) 337-1203
Fax
(224) 337-1204
NPI assigned
Mar 17, 2022
Last updated
Apr 4, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ALL-STAT PORTABLE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Authorized official

Name
Mr. Etai Sooliman
Title
Ceo
Phone
(224) 337-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

515 Ship St Ste 209
Saint Joseph, MI 49085-1155

Mailing address

8235 Christiana Ave
Skokie, IL 60076-2910
Phone (224) 337-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220930001358 MI Part B Supplier - Portable X-Ray Supplier 6507242526 Practice locations: Saint Joseph, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881342863. Details of each certification follow.

Portable X-ray supplier certification: CCN 23X0009843

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
ALL-STAT PORTABLE MI
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Sep 26, 2023
Last certification
Sep 26, 2023
Ownership / control type
Corporation
Facility address
515 Ship St, Suite 209
Saint Joseph, MI 49085

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
All-Stat Portable Mi LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649030400000",
    "number": "1881342863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 CHRISTIANA AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762910",
            "telephone_number": "224-337-1000",
            "fax_number": "224-337-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SHIP ST STE 209",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851155",
            "telephone_number": "224-337-1203",
            "fax_number": "224-337-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL-STAT PORTABLE MI LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALL-STAT PORTABLE LLC",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "SOOLIMAN",
        "authorized_official_first_name": "ETAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-337-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.