NPIMap

Organization Active NPI

Castro Valley Open MRI Medical Group Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Castro Valley, CA
National Provider Identifier
1942592837
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
C3357822 Issued in CA
Legal business name
CASTRO VALLEY OPEN MRI MEDICAL GROUP INC
Practice address
21030 Redwood Rd
Suite B
Castro Valley, CA 94546-5920
Phone
(510) 856-4800
Fax
(510) 259-9103
NPI assigned
May 10, 2011
Last updated
Sep 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Dr. Douglas J. Abeles, M.D.NPI 1508961582
Title
Owner/Medical Director
Phone
(510) 538-1868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X C3357822 CA Primary

Addresses

Primary practice location

21030 Redwood Rd
Suite B
Castro Valley, CA 94546-5920

Mailing address

21030 Redwood Rd
Suite B
Castro Valley, CA 94546-5920
Phone (510) 856-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111020000573 CA Part B Supplier - Clinic/Group Practice 2769654524 Receives reassigned benefits from 5 practitioners
Practice locations: Castro Valley, CA

National Provider Directory

National Provider Directory

Locations

21030 Redwood Rd
Ste B
Castro Valley, CA 94546
Phone (510) 856-4800

Practitioners & affiliated clinicians

Practitioners 5

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": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1942592837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21030 REDWOOD RD",
            "address_2": "SUITE B",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465920",
            "telephone_number": "510-856-4800",
            "fax_number": "510-259-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21030 REDWOOD RD",
            "address_2": "SUITE B",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465920",
            "telephone_number": "510-856-4800",
            "fax_number": "510-259-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTRO VALLEY OPEN MRI MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "ABELES",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "510-538-1868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "CA",
            "license": "C3357822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.