Oklahoma Prostate Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

OKLAHOMA PROSTATE IMAGING, LLC

Practice address

8516 S Portland Avenue
Oklahoma City, OK 73159

Phone

(918) 798-9160

NPI assigned

Aug 22, 2023

Last updated

Aug 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David James Raubach

Title

Officer

Phone

(918) 798-9160

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Premier Breast Health Institute of Oklahoma LLC

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
  • NPI 1538860234

  Member Of

  NPD member

Practitioners 2

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.

• Gautam Dehadrai, MD

  • Diagnostic Radiology Physician
  • Norman, OK
  • NPI 1982653424
  Medicare reassignment Care Compare group NPD
• Anna Stidham, M.D.

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
  • NPI 1114066180
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1982488854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8516 S PORTLAND AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73159",
            "telephone_number": "918-798-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8516 S PORTLAND AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73159",
            "telephone_number": "918-798-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA PROSTATE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "RAUBACH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "918-798-9160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oklahoma Podiatric Medicine & Surgery PLLC
• Oklahoma Post Acute Cardiology Specialist
• Oklahoma Post Acute Nephrology Specialist
• Oklahoma Post Acute Pulmonary Specialist
• Oklahoma Procure Management, LLC (ProCure Proton Therapy Center)
• Oklahoma Proton Center LLC
• Oklahoma Proton Radiation Oncology Group PC
• Oklahoma Psychological Center
• Oklahoma Pulmonary and Critical Care PLLC
• Oklahoma Pulmonary Physicians, Inc.

• Radiology Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Radiology Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.