NPIMap

Organization Active NPI

Chesapeake Diagnostic Imaging Centers, LLC

Doing business as Chesapeake Regional Imaging Center of Kingsborough

  • Diagnostic Radiology Physician
  • Chesapeake, VA
National Provider Identifier
1922056241
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CHESAPEAKE DIAGNOSTIC IMAGING CENTERS, LLC
Doing business as
Chesapeake Regional Imaging Center of Kingsborough
Practice address
676 Kingsborough SQ
Suite a
Chesapeake, VA 23320-4954
Phone
(757) 547-4155
Fax
(757) 547-7631
NPI assigned
May 5, 2006
Last updated
Mar 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Tracey Mason
Title
Billing Manager
Phone
(757) 965-4151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

676 Kingsborough SQ
Suite a
Chesapeake, VA 23320-4954

Mailing address

1554 River Birch Run N
Chesapeake, VA 23320-7500
Phone (757) 965-4151

Other identifiers 1

IdentifierTypeStateIssuer
1922056241MedicaidVA

Other names 1

  • Chesapeake Regional Imaging Center of Kingsborough Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA, CT, NC4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20140422001068 VA Part B Supplier - Clinic/Group Practice 3678524576 Receives reassigned benefits from 43 practitioners
1 other NPI on this enrollment
Practice locations: Chesapeake, VA
O20210525001194 CA Part B Supplier - Clinic/Group Practice 3678524576 1 other NPI on this enrollment
Practice locations: Encinitas, CA
O20210617000466 CT Part B Supplier - Clinic/Group Practice 3678524576 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burlington, CT
O20220331001219 NC Part B Supplier - Clinic/Group Practice 3678524576 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Clayton, NC

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

2760 Pelham Pkwy
Ste 1
Pelham, AL 35124

1034 Battlefield Blvd S
#110
Chesapeake, VA 23322
Phone (757) 671-1144

676 Kingsborough Sq
Ste A
Chesapeake, VA 23320
Phone (757) 547-4155

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1922056241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 RIVER BIRCH RUN N",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233207500",
            "telephone_number": "757-965-4151",
            "fax_number": "757-965-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 KINGSBOROUGH SQ",
            "address_2": "SUITE A",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204954",
            "telephone_number": "757-547-4155",
            "fax_number": "757-547-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE DIAGNOSTIC IMAGING CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "757-965-4151"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922056241",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Regional Imaging Center of Kingsborough",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chesapeake Regional Imaging Center of Kingsborough",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.