NPIMap

Organization Active NPI

Jersey Advanced MRI and Diagnostic Center

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Jackson, NJ
National Provider Identifier
1942555131
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
23139 Issued in NJ
Legal business name
JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER
Practice address
1 Kathleen Dr
Suite 4
Jackson, NJ 08527-2276
Phone
(732) 901-6745
Fax
(732) 901-7550
NPI assigned
Jul 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Mr. Abdur Rehman
Title
Owner
Phone
(732) 901-6745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X 23139 NJ Primary

Addresses

Primary practice location

1 Kathleen Dr
Suite 4
Jackson, NJ 08527-2276

Mailing address

1 Kathleen Dr
Suite 4
Jackson, NJ 08527-2276
Phone (732) 901-6745

Other names 1

  • JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140617000918 NJ Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7113141946 Practice locations: Jackson, NJ

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Jersey Advanced MRI2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1942555131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KATHLEEN DR",
            "address_2": "SUITE 4",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272276",
            "telephone_number": "732-901-6745",
            "fax_number": "732-901-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KATHLEEN DR",
            "address_2": "SUITE 4",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272276",
            "telephone_number": "732-901-6745",
            "fax_number": "732-901-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "REHMAN",
        "authorized_official_first_name": "ABDUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-901-6745",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NJ",
            "license": "23139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.