NPIMap

Organization Active NPI

Mobile Diagnostic Testing Services Inc

Doing business as HealthTrac

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Buffalo, NY
National Provider Identifier
1902916448
Registry record updated Nov 4, 2008
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
MOBILE DIAGNOSTIC TESTING SERVICES INC
Doing business as
HealthTrac
Practice address
4950 Genesee St
Suite 180
Buffalo, NY 14225-5550
Phone
(716) 614-3260
Fax
(716) 614-3282
NPI assigned
Aug 30, 2006
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Alan Robinson
Title
President
Phone
(716) 614-3285

Specialties & licenses 1

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

Addresses

Primary practice location

4950 Genesee St
Suite 180
Buffalo, NY 14225-5550

Mailing address

4950 Genesee St
Suite 180
Buffalo, NY 14225-5550
Phone (716) 614-3260

Other identifiers 6

IdentifierTypeStateIssuer
01712505MedicaidNY
7602181OtherNYIHA
000510159003OtherNYBCBS WNY
0073926OtherNYGHI
00020000502OtherNYUNIVERA
01867490MedicaidNY

Other names 1

  • HealthTrac Doing business as

Medicare participation

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902916448. Details of each certification follow.

Portable X-ray supplier certification: CCN 33X0009862

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
CLOSED -- MOBILE DIAGNOSTIC TESTING SERV
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Mar 20, 1992
Last certification
May 22, 2001
Ownership / control type
CORPORATION
Facility address
4950 Genesee Street, Suite 180
Buffalo, NY 14225

National Provider Directory

National Provider Directory

Locations

8678 Lake Street Rd
Le Roy, NY 14482
Phone (585) 344-4444

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1902916448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 GENESEE ST",
            "address_2": "SUITE 180",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142255550",
            "telephone_number": "716-614-3260",
            "fax_number": "716-614-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 GENESEE ST",
            "address_2": "SUITE 180",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142255550",
            "telephone_number": "716-614-3260",
            "fax_number": "716-614-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DIAGNOSTIC TESTING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-614-3285"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01712505",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "7602181",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WNY",
            "identifier": "000510159003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0073926",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020000502",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01867490",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthTrac",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.