Organization Active NPI

Coastal Imaging Associates, PLLC

  • Diagnostic Radiology Physician
  • Beaumont, TX
National Provider Identifier
1952833717
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
COASTAL IMAGING ASSOCIATES, PLLC
Practice address
3080 College St
Beaumont, TX 77701-4606
Phone
(409) 728-7736
NPI assigned
Mar 31, 2017
Last updated
Oct 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Robert Morrison III, M.D.NPI 1922291863
Title
Authorized Signer
Phone
(409) 728-7736

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
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

3080 College St
Beaumont, TX 77701-4606

Mailing address

PO Box 7708
Beaumont, TX 77726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR, LA, MO, FL, CA, AZ, NY8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20170603000042 TX Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 15 practitioners
Practice locations: Beaumont, TX; Orange, TX; Port Arthur, TX
O20230721003516 AR Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR
O20230726002317 LA Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 2 practitioners
Practice locations: Lafayette, LA
O20231116001523 MO Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, MO; Springfield, MO
O20231120003684 FL Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL
O20231121003983 CA Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington Beach, CA
O20231204003144 AZ Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ
O20240806000119 NY Part B Supplier - Clinic/Group Practice 2163799685 Receives reassigned benefits from 1 practitioner
Practice locations: Smithtown, NY

National Provider Directory

National Provider Directory

Locations

3080 Milam St
Beaumont, TX 77701
Phone (409) 347-3621

1200 E Campbell Rd
Richardson, TX 75081

1200 E Campbell Rd
#R
Richardson, TX 75081

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1952833717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7708",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-728-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL IMAGING ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-31",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "409-728-7736",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.