DIAGNOSTIC RADIOLOGISTS PC – NPI #1053368563
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

DIAGNOSTIC RADIOLOGISTS PC is a radiologist located in PORTLAND, OR. NPPES has assigned the NPI number 1053368563 to DIAGNOSTIC RADIOLOGISTS PC on May 28, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was last updated on Oct 29, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DIAGNOSTIC RADIOLOGISTS PC below.

NPI Profile for
DIAGNOSTIC RADIOLOGISTS PC

NPI Number
1053368563
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DIAGNOSTIC RADIOLOGISTS PC
Primary location
10123 SE MARKET
PORTLAND, OR 97216
Phone: (503) 251-6132 Fax: (503) 251-6136
2 Other location(s):
640 Ulukahiki St
Kailua, HI 96734-4454
Phone: (503) 251-6132
831 NW Council Dr
Gresham, OR 97030-3721
Phone: (503) 251-6132
Mailing address
PO BOX 16961
PORTLAND, OR 97292-0961
Phone: 0352516855 Fax: (503) 251-6136
Organization Subpart
No
Authorized Official
JED PETERSON
PRESIDENT
Phone: (503) 251-6132
Updated
Certification Date
Oct 29, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for DIAGNOSTIC RADIOLOGISTS PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidHIH110076
medicaidOR064972
medicaidWA7805609
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.