PROVIDENCE DIAGNOSTIC IMAGING INC. NPI 1609978170

NPI Information

NPI: 1609978170
Provider Name: PROVIDENCE DIAGNOSTIC IMAGING, INC.
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
271 CAREW ST
SPRINGFIELD, MA
ZIP 01104
Phone: (413) 748-9200
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PROVIDENCE DIAGNOSTIC IMAGING, INC. is a diagnostic radiology radiology in Springfield, MA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PROVIDENCE DIAGNOSTIC IMAGING, INC. NPI is 1609978170. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

271 CAREW ST
SPRINGFIELD, MA
ZIP 01104-377
Phone: (413) 748-9200

The provider's authorized official is Gregory E. Blackman .
The authorized official title is President and has the following contact phone number (413) 748-9200.

The enumeration date for this NPI number is 9/3/2006 and was last updated on 7/1/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	2085B0100X	Radiology	Body Imaging	No
2	2085N0700X	Radiology	Neuroradiology	No
3	2085N0904X	Radiology	Nuclear Radiology	No
4	2085R0204X	Radiology	Vascular & Interventional Radiology	No
5	2085U0001X	Radiology	Diagnostic Ultrasound	No
6	2085R0202X	Radiology	Diagnostic Radiology	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	774327	OTHER		CONNECTICARE
2	M20051	MEDICARE PIN	MASSACHUSETTS
3	755228	OTHER	MASSACHUSETTS	TUFTS
4	CA7920	OTHER		RAILROAD MEDICARE
5	000000025268	OTHER	MASSACHUSETTS	BMC HEALTHNET PLAN
6	1601748	OTHER		EVERCARE
7	M16237	OTHER	MASSACHUSETTS	BLUE CROSS/BLUE SHIELD
8	003126358	MEDICAID	CONNECTICUT
9	102940700	OTHER		US DEPARTMENT OF LABOR
10	783230	OTHER	MASSACHUSETTS	AETNA/US HEALTHCARE
11	98133101	OTHER	MASSACHUSETTS	NETWORK HEALTH
12	9776559	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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