JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC (NPI# 1104376797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104376797 |
| Entity Type | Organization |
| Organization Name | JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC |
| Other Organization Name | JEFFERSON OUTPATIENT IMAGING |
| Practice Address |
9601 Bustleton Ave Philadelphia PA 19115-3810 |
| Mailing Address |
840 Crescent Centre Dr Ste 200 Franklin TN 37067-4652 |
| Practice Telephone | 2156765100 |
| Mailing Telephone | 6152502281 |
| Mailing Fax Number | 6155506004 |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-12-14 |
| Authorized Official Name | MR. WILLIAM PERRY BAKER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6155506000 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jefferson Outpatient Imaging | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678352 | Jefferson University Radiology Associates, LLC | Radiology | 243 Hurffville Crosskeys Rd, Sewell, NJ 08080-4011 | 2020-01-07 |
| 1063067635 | Jefferson University Radiology Associates, LLC | Radiology | 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 | 2019-08-09 |
| 1972169902 | Jefferson University Radiology Associates, LLC | Radiology | 999 Nj-73, # 101, Marlton, NJ 08053 | 2019-05-15 |
| 1902114168 | Jefferson University Radiology Associates, LLC | Physiological Laboratory | 1 W Germantown Pike, East Norriton, PA 19401-1513 | 2010-09-21 |
| 1710492764 | Jefferson University Radiology Associates, LLC | Radiology | 650 Carnegie Boulevard, Malvern, PA 19355-1935 | 2017-12-12 |
| 1083907364 | Jefferson University Radiology Associates, LLC | Radiology | 1 W Germantown Pike, East Norriton, PA 19401-1513 | 2011-05-19 |
| 1144559444 | Jefferson University Radiology Associates, LLC | Radiology | 470 John Young Way, Suite #100, Exton, PA 19341-2557 | 2009-12-15 |
| 1275718561 | Jefferson University Radiology Associates, LLC | Radiology | 170 N Henderson Rd, Suites 103 & 104, King of Prussia, PA 19406-2155 | 2008-01-04 |
| Street Address |
9601 BUSTLETON AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19115-3810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578520243 | Michael S Nalbantian | Radiology | 9601 Bustleton Ave, Philadelphia, PA 19115 | 2006-04-27 |
| 1316985310 | Alpha Medical Group,ltd. | Radiology | 9601 Bustleton Ave, Lower Level, Philadelphia, PA 19115-3810 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442696 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2044 Red Lion Road, Philadelphia, PA 19115 | 2020-09-21 |
| 1639717762 | Cassondra Ondeck | Physical Therapist | Paul's Run Retirement Community, 9896 Bustleton Ave, Philadelphia, PA 19115 | 2019-12-19 |
| 1740747641 | Comfort Ride Transit Inc | Non-emergency Medical Transport (VAN) | 248 Geiger Road, Suite 201 Unit D, Philadelphia, PA 19115 | 2019-02-27 |
| 1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
| 1659857027 | Kiesha Anita Abney | Occupational Therapy Assistant | Chapel Manor (genesis Rehabilitation) 1104 Welsh Road, Philadelphia, PA 19115 | 2018-07-18 |
| 1457844870 | Philadelphia Discount Pharmacy LLC | Pharmacist | 842 Red Lion Road Unit 13, Philadephia, PA 19115 | 2018-06-11 |
| 1770001828 | Ciarra Bell | Occupational Therapist | 828 Red Lion Rd, Philadelphia, PA 19115 | 2017-09-08 |
| 1245604008 | Saria Ibrahim | Counselor | 9651 Clark Street, Philadelphia, PA 19115 | 2015-11-17 |
| 1124413166 | Global Dental Plus LLC | Dentist | 9630 Bustleton Av 2nd Fl, Philadelphia, PA 19115 | 2015-04-06 |
| 1932510161 | Miriam John | Occupational Therapist | 9997 Sandy Road, Philadelphia, PA 19115 | 2014-05-09 |
| Find all providers in zip 19115 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063067635 | Jefferson University Radiology Associates, LLC | Radiology | 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 | 2019-08-09 |
| 1033649975 | Dinh-huy Do Nguyen | Radiology | 5501 Old York Rd Ste 363, Philadelphia, PA 19141-3018 | 2017-06-13 |
| 1467809418 | Jeffrey Burgess | Radiology | 1215 Spruce St Apt 201, Philadelphia, PA 19107-5620 | 2016-05-19 |
| 1649632399 | Myron Blumberg | Radiology | 317 S 22nd St, Philadelphia, PA 19103-6528 | 2016-03-22 |
| 1144633074 | Daniel Robert Wahl | Radiology | 3400 Spruce Street - 1 Silverstein, Department of Radiology / Abdominal Imaging, Philadelphia, PA 19104 | 2014-06-09 |
| 1235564337 | Ron Benjamin | Radiology | 2055 E Fletcher St, Philadelphia, PA 19125 | 2013-09-08 |
| 1831454867 | Ryan Michael Bonshock | Radiology | 4220 Market St Fl 2, Philadelphia, PA 19104-3007 | 2012-07-05 |
| 1730498601 | Robert A Perkins Jr. | Radiology | 132 S 10th St Ste 1099j, Philadelphia, PA 19107-5244 | 2010-09-27 |
| 1457677007 | Michael Richard Acord | Radiology | 3401 Civic Blvd, Division of Radiology, Philadelphia, PA 19104 | 2010-04-07 |
| 1780918375 | Mollie Mcginley | Radiology | 1835 Arch St, Apartment 305, Philadelphia, PA 19103-2712 | 2009-09-29 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19115 |
Please comment or provide details below to improve the information on JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.