Nick Maravich (NPI# 1104828599, PAC ID# 6709817281) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1104828599 |
| PAC ID by PECOS | 6709817281 |
| Professional Enrollment ID | I20050824000676 |
| Full Name | Nick Maravich |
| Organization Legal Name | LARCHMONT IMAGING ASSOCIATES LLC |
| Address |
219 Sunset Rd Willingboro NJ 08046-1109 |
| Phone Number | 6092614500 |
| Gender | M |
| Credential | MD |
| Medical School | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 1994 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 5193762433 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310057 | VIRTUA MEMORIAL |
| 310022 | VIRTUA WEST JERSEY HOSPITALS |
| Address | Phone | Organization |
|---|---|---|
| 103 Old Marlton Pike, Medford, NJ 08055-8772 | 6092614500 | LARCHMONT IMAGING ASSOCIATES LLC |
| 175 Madison Ave, Mount Holly, NJ 08060-2038 | 6092670700 | RADIOLOGY ASSOCIATES OF BURLINGTON COUNTY, P.A. |
| 210 Ark Rd, Mount Laurel, NJ 08054-3188 | 6092614500 | LARCHMONT IMAGING ASSOCIATES LLC |
| 219 Sunset Rd, Willingboro, NJ 08046-1109 | 6092614500 | LARCHMONT IMAGING ASSOCIATES LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 98% | |
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 98% |
| Organization Legal Name | LARCHMONT IMAGING ASSOCIATES LLC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Howard S Berinson | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Darren Andrew Bialo | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Robert Todd Harvey | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Sungtae Lim | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Kevin P Barry | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Karl Christopher Schlobohm | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Azam H Rizvi | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Barry J Livstone | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Elizabeth L Tan | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Ben M Yang | Diagnostic Radiology | Larchmont Imaging Associates LLC | 210 Ark Rd, Mount Laurel, NJ 08054-3188 |
| Street Address |
219 SUNSET RD |
| City | WILLINGBORO |
| State | NJ |
| Zip | 08046-1109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael C Brodsky | Diagnostic Radiology | Larchmont Imaging Associates LLC | 219 Sunset Rd, Willingboro, NJ 08046-1109 |
| Manan J Patel | Diagnostic Radiology | Larchmont Imaging Associates LLC | 219 Sunset Rd, Willingboro, NJ 08046-1109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Odette M Cohen Martin | Pediatric Medicine | 2 D E Ridge Plaza, Willingboro, NJ 08046 | |
| Ashley V Weinmann | Nurse Practitioner | 4390 Route 130, Suite A, Willingboro, NJ 08046-1065 | |
| Amanda Gardiner | Physical Therapy | Ivyrehab Network Inc | 200 Campbell Dr, Suite 107, Willingboro, NJ 08046-1067 |
| Candace L Bromley | Physician Assistant | Lourdes Medical Associates Pa | 200 Campbell Dr, Suite 102, Willingboro, NJ 08046-1067 |
| Adriana L Davis | Family Medicine | Lourdes Medical Associates Pa | 200 Campbell Dr, Suite 102, Willingboro, NJ 08046-1067 |
| Richa Shah | Physical Therapy | Ivyrehab Network Inc | 200 Campbell Dr, Suite 107, Willingboro, NJ 08046-1067 |
| James A Shimp | Physical Therapy | Ivyrehab Network Inc | 200 Campbell Dr, Suite 107, Willingboro, NJ 08046-1067 |
| Jasmine K Bajaj | Family Medicine | Lourdes Medical Associates Pa | 200 Campbell Dr, Suite 102, Willingboro, NJ 08046-1067 |
| Richard Tucker | Obstetrics/gynecology | Regional Womens Health Group LLC | 200 Campbell Dr, Suite 101, Willingboro, NJ 08046-1067 |
| Anthony J Vendetti | Physical Therapy | Ivyrehab Network Inc | 200 Campbell Dr, Suite 107, Willingboro, NJ 08046-1067 |
| Find all physicians in zip 08046 | |||
| City | WILLINGBORO |
| Zip Code | 08046 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | WILLINGBORO + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.