Open MRI of Perth Amboy, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

22565 Issued in NJ

Legal business name

OPEN MRI OF PERTH AMBOY, LLC

Doing business as

Raritan Bay Medical Imaging

Practice address

551 New Brunswick Ave
Perth Amboy, NJ 08861-3658

Phone

(732) 442-4240

Fax

(732) 442-5404

NPI assigned

Dec 23, 2005

Last updated

May 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ivette Cuevas, RN

Title

Facility Administrator

Phone

(732) 721-5501

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Raritan Bay Medical Imaging Doing business as

Practitioners 2

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.

• Martin I Parker, M.D.

  • Diagnostic Radiology Physician
  • Edison, NJ
  • NPI 1295715688
  NPD (past)
• Lawrence Neil Tanenbaum, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1851371272
  NPD (past)

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1932186608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3069",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088793069",
            "telephone_number": "732-721-5501",
            "fax_number": "732-721-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613658",
            "telephone_number": "732-442-4240",
            "fax_number": "732-442-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI OF PERTH AMBOY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "IVETTE",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-721-5501",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "22565",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "22565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8013403",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HEALTH/HUMAN SER",
            "identifier": "22565",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raritan Bay Medical Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.