NPIMap

Individual provider Active NPI

Marsela Hyska Campbell, DO

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1972918118
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DO00948 Issued in RI
Practice address
1111 Colombo St
Jacksonville, FL 32207-3013
Phone
(904) 800-9151
NPI assigned
Jun 26, 2014
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS13618 FL
Diagnostic Radiology Physician 2085R0202X 286603 MA
Diagnostic Radiology Physician 2085R0202X UO4283 FL
Diagnostic Radiology Physician 2085R0202X DO00948 RI Primary

Addresses

Primary practice location

1111 Colombo St
Jacksonville, FL 32207-3013

Mailing address

1111 Colombo St
Jacksonville, FL 32207-3013
Phone (904) 800-9151

Other practice location 1

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2520

Other practice location 2

211 Park St
Attleboro, MA 02703-3137
Phone (508) 222-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230201000965 CO Practitioner - Diagnostic Radiology 1658670245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Michigan State University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Springs Radiologists PCGroup PAC ID 6901890094, 27 clinicians
Penrad Imaging LLCGroup PAC ID 1850387598, 26 clinicians

Practice addresses (Care Compare)

2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone (719) 265-3775

3050 N Circle Dr
Colorado Springs, CO 80909-1175
Phone (719) 593-1799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as group
Quality
76.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS13618FLMDFamily Medicine Physician
UO4283FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penrad Imaging LLC CurrentSince Jan 1, 2023 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology PastSince Jun 26, 2022 Accepting new patients

Locations

6011 E Woodmen Rd
Ste 10
Colorado Springs, CO 80923

1390 Kelly Johnson Blvd
Colorado Springs, CO 80920
Phone (714) 400-6934

3050 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 550-1200

Organizations & group practices 4

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.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1972918118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 COLOMBO ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073013",
            "telephone_number": "904-800-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 COLOMBO ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073013",
            "telephone_number": "904-800-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Metro Center Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861785",
            "country_code": "US",
            "telephone_number": "401-432-2520",
            "fax_number": "401-921-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Park St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027033137",
            "country_code": "US",
            "telephone_number": "508-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYSKA CAMPBELL",
        "first_name": "MARSELA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13618",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "286603",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "UO4283",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "DO00948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.