Provider Demographics
NPI:1184660037
Name:IMAGING CONSULTANTS, INC.
Entity Type:Organization
Organization Name:IMAGING CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-552-2600
Mailing Address - Street 1:600 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1039
Mailing Address - Country:US
Mailing Address - Phone:978-552-2600
Mailing Address - Fax:
Practice Address - Street 1:840 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2905
Practice Address - Country:US
Practice Address - Phone:617-638-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA440413261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA785146OtherCONNECTICARE
MA9752731 BMedicaid
MA0421008OtherCIGNA / HEALTHSOURCE
MA36984OtherFALLON
MA9758861Medicaid
MA036769OtherBCBS
MA13270OtherHEALTH NEW ENGLAND
MA626264OtherHARVARD PILGRIM HLTH CARE
MA0008850OtherNEIGHBORHOOD HEALTH PLAN
MA713587OtherTUFTS/SECURE HORIZONS
MA81020OtherAETNA
MA9752731 BMedicaid
MA9758861Medicaid