NPIMap

Organization Active NPI

MRI Associates of St Pete Inc

Doing business as St Pete MRI

  • Radiology Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1972518405
Registry record updated Sep 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
HCC3960 Issued in FL
Legal business name
MRI ASSOCIATES OF ST PETE INC
Doing business as
St Pete MRI
Practice address
750 94TH Ave N Ste 206
St Petersburg, FL 33702-2453
Phone
(727) 577-2220
Fax
(727) 578-6452
NPI assigned
Jul 31, 2006
Last updated
Sep 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2008

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

Authorized official

Name
Ms. Kimberly Mahoney
Title
Owner
Phone
(727) 577-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X HCC3960 FL Primary

Addresses

Primary practice location

750 94TH Ave N Ste 206
St Petersburg, FL 33702-2453

Mailing address

750 94TH Ave N Ste 206
St Petersburg, FL 33702-2453
Phone (727) 577-2220

Other identifiers 1

IdentifierTypeStateIssuer
276042800MedicaidFL

Other names 1

  • St Pete MRI Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050223000180 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0648223396 Practice locations: St Petersburg, FL
O20250728003657 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0648223396 Practice locations: St Petersburg, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2052502Saint Pete MRI750 94TH Ave N Ste 206, Saint Petersburg, FL 33702Certificate of waiverJan 10, 2027

National Provider Directory

National Provider Directory

Locations

6101 Central Ave
St Petersburg, FL 33710
Phone (727) 381-4674

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222041600000",
    "number": "1972518405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 94TH AVE N STE 206",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022453",
            "telephone_number": "727-577-2220",
            "fax_number": "727-578-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 94TH AVE N STE 206",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022453",
            "telephone_number": "727-577-2220",
            "fax_number": "727-578-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRI ASSOCIATES OF ST PETE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-09-22",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-577-2220",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "FL",
            "license": "HCC3960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276042800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Pete MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.