Individual provider Active NPI

Kristopher Aghemo, DO

  • Diagnostic Radiology Physician
  • Weatherford, TX
National Provider Identifier
1972091742
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS19745 Issued in FL
Practice address
713 E Anderson St
Weatherford, TX 76086-5705
Phone
(954) 547-8055
NPI assigned
Apr 27, 2018
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X OS19745 FL Primary

Addresses

Primary practice location

713 E Anderson St
Weatherford, TX 76086-5705

Mailing address

713 E Anderson St
Weatherford, TX 76086-5705
Phone (954) 547-8055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230728001683 NC Practitioner - Diagnostic Radiology 2163770843 Reassigns benefits to 1 organization
I20240812002322 FL Practitioner - Diagnostic Radiology 2163770843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians
Simonmed Imaging Florida LLCGroup PAC ID 6608036108, 302 clinicians

Practice addresses (Care Compare)

10010 N Dale Mabry Hwy 150
Simonmed Imaging Carrollwood
Tampa, FL 33618-4469
Phone (813) 964-8439

3015 N Rocky Point Dr E Unit
Tampa, FL 33607-6094
Phone (480) 306-6949

4051 Upper Creek Dr
Suite 103a
Sun City Center, FL 33573-6848
Phone (813) 634-0010

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
75.71
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
75.71
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS19745FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Jul 25, 2023 Accepting new patients
Simonmed Imaging Florida LLC Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Smi Imaging, LLC Diagnostic Radiology CurrentSince Aug 27, 2024 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Jul 25, 2023 Accepting new patients

Locations

15810 S 45th St
Ste 110
Phoenix, AZ 85048
Phone (480) 743-6161

20414 N 27th Ave
Ste 150
Phoenix, AZ 85027
Phone (623) 234-2520

16220 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254

208 W Oak St
Kissimmee, FL 34741
Phone (407) 788-2888

4051 Upper Creek Dr
Ste 10
Sun City Ctr, FL 33573
Phone (813) 634-0010

10010 N Dale Mabry Hwy
Ste 150
Tampa, FL 33618
Phone (725) 937-6006

14302 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 975-1111

861 Old Winston Rd
Ste 105
Kernersville, NC 27284
Phone (336) 765-5722

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1972091742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 E ANDERSON ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865705",
            "telephone_number": "954-547-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 E ANDERSON ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865705",
            "telephone_number": "954-547-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGHEMO",
        "first_name": "KRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS19745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.