NPIMap

Organization Active NPI

Proscan Tylersville, LLC

  • Diagnostic Radiology Physician
  • Liberty Township, OH
National Provider Identifier
1972593093
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0868IC Issued in OH
Legal business name
PROSCAN TYLERSVILLE, LLC
Practice address
7003 Loomis LN
Liberty Township, OH 45069-3898
Phone
(513) 759-7350
Fax
(513) 759-7351
NPI assigned
Oct 28, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Karen Amaya
Title
Coo
Phone
(513) 281-3400

Practitioners 51

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

View all 51

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040122001212 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3779485453 Practice locations: Liberty Township, OH

National Provider Directory

National Provider Directory

Locations

7003 Loomis Ln
Liberty Township, OH 45069
Phone (513) 759-7350

7307 Tylers Corner Dr
West Chester, OH 45069
Phone (513) 759-7350

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 0868IC OH Primary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X

Addresses

NPPES NPI Registry

Primary practice location

7003 Loomis LN
Liberty Township, OH 45069-3898

Mailing address

7003 Loomis LN
Liberty Township, OH 45069-3898
Phone (513) 759-7350

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2356203MedicaidOH
000000332731OtherOHANTHEM PIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 12, 2024.

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1972593093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7003 LOOMIS LN",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450693898",
            "telephone_number": "513-759-7350",
            "fax_number": "513-759-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 LOOMIS LN",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450693898",
            "telephone_number": "513-759-7350",
            "fax_number": "513-759-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSCAN TYLERSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "AMAYA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "513-281-3400"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "0868IC",
            "primary": true
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2356203",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000332731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Township, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.