PROACTIVE IMAGING LLC NPI 1619970910

NPI Information

  • NPI: 1619970910
  • Provider Name: PROACTIVE IMAGING LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Doing Business As: MINNESOTA RADIOLOGY
  • Address: 4000 W 76TH ST
    STE 100
    EDINA, MN
    ZIP 55435
  • Phone: (952) 853-7226

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NPI Details

PROACTIVE IMAGING LLC is a diagnostic radiology radiology in Edina, MN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PROACTIVE IMAGING LLC NPI is 1619970910. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Minnesota Radiology.

The provider's business location address is:

4000 W 76TH ST
STE 100
EDINA, MN
ZIP 55435-104
Phone: (952) 853-7226
Fax: (952) 831-7555

The provider's authorized official is Angel L Soto .
The authorized official title is President and has the following contact phone number (954) 559-2421.

The enumeration date for this NPI number is 5/31/2005 and was last updated on 10/2/2008.

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 License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology540MINNESOTAYes

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
1300002980MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
2P00053758OTHERMINNESOTAMEDICARE RAILROAD
322030077OTHERMINNESOTAOFFICE OF WORK COMP.

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: 3/30/2025

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