Radiology Medical Group of Santa Cruz County Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

RADIOLOGY MEDICAL GROUP OF SANTA CRUZ COUNTY INC

Practice address

75 Nielsen Street
Watsonville, CA 95076

Phone

(831) 724-2236

Fax

(831) 724-8440

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Kenneth E Averill Jr., MD

Title

President

Phone

(831) 476-1542

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Watsonville Community Hospital Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Radiology Medical Group of Santa Cruz County Inc

  • Diagnostic Radiology Physician
  • Santa Cruz, CA
  • NPI 1962415208

  O20040426001018

  Same enrollment
• Radiology Medical Group of Santa Cruz County Inc.

  • Diagnostic Radiology Physician
  • Hollister, CA
  • NPI 1265857759

  O20040426001018

  Same enrollment

Tax ID family

RMG GRP DSCH6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Radiology Medical Group of Santa Cruz County Inc

  • Diagnostic Radiology Physician
  • Freedom, CA
  • NPI 1306854294
  NPD tax ID
• Radiology Medical Group of Santa Cruz County Inc

  • Diagnostic Radiology Physician
  • Santa Cruz, CA
  • NPI 1619987674
  NPD tax ID
• Radiology Medical Group of Santa Cruz County Inc

  • Diagnostic Radiology Physician
  • Santa Cruz, CA
  • NPI 1780692673
  NPD tax ID
• Radiology Medical Group of Santa Cruz County Inc

  • Diagnostic Radiology Physician
  • Santa Cruz, CA
  • NPI 1962415208
  NPD tax ID
• Radiology Medical Group of Santa Cruz County Inc

  • Diagnostic Radiology Physician
  • Santa Cruz, CA
  • NPI 1992715601
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roy Elias Martinez, M.D.

  • Diagnostic Radiology Physician
  • Santa Cruz, CA
  • NPI 1093714511
  NPD
• Juan Roberto Rodriguez, MD

  • Diagnostic Radiology Physician
  • Salinas, CA
  • NPI 1942235254
  NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1922016815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 GREEN VALLEY ROAD",
            "address_2": "SUITE B",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193110",
            "telephone_number": "831-724-2236",
            "fax_number": "831-724-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NIELSEN STREET",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "95076",
            "telephone_number": "831-724-2236",
            "fax_number": "831-724-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY MEDICAL GROUP OF SANTA CRUZ COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "AVERILL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-476-1542",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ70814Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watsonville Community Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ruby Quilindo Fernandez
• Martha Patricia Quintana, RN,BSN,PHN, CDE
• Leslie Quintero, CMT
• Isidro Ramon Quiroga, PH.D.
• Maria Concepcion Quiroz Mendoza, APCC
• Madhu Raghavan, M.D
• Raices Y Carino, LLC
• Brooke Kondo Rains, D.D.S.
• Rajeshwary Swamidurai MD Inc
• Luis Jesus Rameno

• Diagnostic Radiology Physician in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.