NPIMap

Organization Active NPI

George L Rodriguez MD PC

Doing business as University Dymanic MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Woodlyn, PA
National Provider Identifier
1912134842
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
GEORGE L RODRIGUEZ MD PC
Doing business as
University Dymanic MRI
Practice address
1326 Macdade Blvd
Woodlyn, PA 19094-1500
Phone
(215) 425-1500
Fax
(215) 425-1659
NPI assigned
Jun 18, 2009
Last updated
Jun 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Authorized official

Name
Ms. Ellen C. Bamba
Title
Practice Administrator
Phone
(215) 425-1500

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X NU Primary
Internal Medicine Physician 207R00000X MD 045274E PA
Internal Medicine Physician 207R00000X NU
Physical Medicine & Rehabilitation Physician 208100000X MD 036647E PA
Physical Medicine & Rehabilitation Physician 208100000X MD-025907 PA
Physical Medicine & Rehabilitation Physician 208100000X NU
Diagnostic Radiology Physician 2085R0202X MD 039238-E PA
Diagnostic Radiology Physician 2085R0202X MD067042L PA
Diagnostic Radiology Physician 2085R0202X MD435786 PA
Diagnostic Radiology Physician 2085R0202X MD422104 PA
Diagnostic Radiology Physician 2085R0202X 131553-1 - NY NY
Diagnostic Radiology Physician 2085R0202X 155494-1 - NY NY
Diagnostic Radiology Physician 2085R0202X MD 072988L PA
Diagnostic Radiology Physician 2085R0202X NU

Addresses

Primary practice location

1326 Macdade Blvd
Woodlyn, PA 19094-1500

Mailing address

841 E Allegheny Ave
Philadelphia, PA 19134-2401
Phone (215) 425-1500

Other identifiers 2

IdentifierTypeStateIssuer
626086OtherPAHIGHMARK BLUE SHIELD
0455759000OtherPAINDEPENDENCE BLUE CROSS

Other names 1

  • University Dymanic MRI Doing business as

National Provider Directory

National Provider Directory
Tax ID family
George L Rodriguez MD PC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Practitioners & affiliated clinicians

Practitioners 1

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": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1912134842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342401",
            "telephone_number": "215-425-1500",
            "fax_number": "215-425-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 MACDADE BLVD",
            "city": "WOODLYN",
            "state": "PA",
            "postal_code": "190941500",
            "telephone_number": "215-425-1500",
            "fax_number": "215-425-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE L RODRIGUEZ MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "BAMBA",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "215-425-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD 045274E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD 036647E",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD-025907",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD 039238-E",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD067042L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD435786",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD422104",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "131553-1 - NY",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "155494-1 - NY",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD 072988L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "626086",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0455759000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Dymanic MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodlyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.