NPIMap

Organization Active NPI

Diagnostic Medical Imaging Enterprises, LTD

  • Physiological Laboratory
  • Northampton, PA
National Provider Identifier
1992784375
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
MD037186E Issued in PA
Legal business name
DIAGNOSTIC MEDICAL IMAGING ENTERPRISES, LTD
Practice address
3330 Pheasant Dr
Northampton, PA 18067-9614
Phone
(610) 261-4898
Fax
(610) 261-4899
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Alex B Bodenstab, MDNPI 1104806025
Title
Medical Director
Phone
(610) 261-4898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X MD037186E PA Primary

Addresses

Primary practice location

3330 Pheasant Dr
Northampton, PA 18067-9614

Mailing address

3330 Pheasant Dr
Northampton, PA 18067-9614
Phone (610) 261-4898

Other identifiers 2

IdentifierTypeStateIssuer
01383052OtherPAHIGHMARK BLUE SHIELD
2086219000OtherPAINDEPENDENCE BLUE CROSS

Other names 1

  • Diagnostic Medical, P. C. Other name

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic Medical Imaging Enterprises LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1992784375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 PHEASANT DR",
            "city": "NORTHAMPTON",
            "state": "PA",
            "postal_code": "180679614",
            "telephone_number": "610-261-4898",
            "fax_number": "610-261-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PHEASANT DR",
            "city": "NORTHAMPTON",
            "state": "PA",
            "postal_code": "180679614",
            "telephone_number": "610-261-4898",
            "fax_number": "610-261-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC MEDICAL IMAGING ENTERPRISES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "BODENSTAB",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "610-261-4898",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "PA",
            "license": "MD037186E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "01383052",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2086219000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Medical, P. C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Northampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.