Provider Demographics
NPI:1508869314
Name:OPEN MRI OF IOWA, L.L.C.
Entity Type:Organization
Organization Name:OPEN MRI OF IOWA, L.L.C.
Other - Org Name:NYDIC OPEN MRI OF AMERICA-DES MOINES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-573-8080
Mailing Address - Street 1:100 PARAGON DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1718
Mailing Address - Country:US
Mailing Address - Phone:201-573-8080
Mailing Address - Fax:201-775-4306
Practice Address - Street 1:7601 OFFICE PLAZA DR N
Practice Address - Street 2:STE 115
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-2338
Practice Address - Country:US
Practice Address - Phone:515-222-0550
Practice Address - Fax:515-222-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6446300OtherCOVENTRY HEALTHCARE OF IA
IA16-00340OtherUNITED HEALTHCARE MIDLAND
IAF246150OtherMIDLANDS CHOICE
IAA-80808OtherMULTIPLAN
IA17063OtherMEDFOCUS
IA44997OtherBCBS OF IOWA
IA0180133Medicaid
IA1126226OtherFIRST HEALTH NETWORK
IA44997OtherWELLMARK BCBS OF IOWA
IA16-00340OtherUNITED HEALTHCARE MIDLAND
IA44997OtherBCBS OF IOWA