NPIMap

Organization Active NPI

San Marcos MRI, LP

Doing business as Advanced Imaging San Marcos

  • Radiology Clinic/Center
  • San Marcos, TX
National Provider Identifier
1992786883
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
R29023 Issued in TX
Legal business name
SAN MARCOS MRI, LP
Doing business as
Advanced Imaging San Marcos
Practice address
1330 Wonder World Dr
Ste 202
San Marcos, TX 78666-7566
Phone
(512) 353-5535
Fax
(512) 353-7797
NPI assigned
Nov 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Mr. Syd G. Vital
Title
Administrator
Phone
(512) 353-5535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X R29023 TX Primary

Addresses

Primary practice location

1330 Wonder World Dr
Ste 202
San Marcos, TX 78666-7566

Mailing address

1330 Wonder World Dr
Ste 202
San Marcos, TX 78666-7566
Phone (512) 353-5535

Other identifiers 1

IdentifierTypeStateIssuer
1724924 01MedicaidTX

Other names 1

  • Advanced Imaging San Marcos Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050315000779 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9931154697 Practice locations: San Marcos, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1992786883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 WONDER WORLD DR",
            "address_2": "STE 202",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667566",
            "telephone_number": "512-353-5535",
            "fax_number": "512-353-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 WONDER WORLD DR",
            "address_2": "STE 202",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667566",
            "telephone_number": "512-353-5535",
            "fax_number": "512-353-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MARCOS MRI, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "VITAL",
        "authorized_official_first_name": "SYD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-353-5535",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": "R29023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1724924 01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Imaging San Marcos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.