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Radiology Associates of Tallahassee PA

NPI 1003866773ActiveOrganization· Radiology, Diagnostic Radiology· Tallahassee, FL

Radiology, Diagnostic Radiology in Tallahassee, Florida, registered in NPPES in May 2006. The authorized official on file is John R. Detelich, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.

Overview

NPI1003866773
StatusActive
Entity typeOrganization
NPI issuedMay 11, 2006
Last updated in NPPESOct 19, 2026
Certified by providerOct 19, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Radiology, Diagnostic Radiology Primary2085R0202X——
Radiology, Body Imaging2085B0100X——
Radiology, Neuroradiology2085N0700X——
Radiology, Neuroradiology, Nuclear Radiology2085N0904X——
Radiology, Pediatric Radiology2085P0229X——
Radiology, Vascular & Interventional Radiology2085R0204X——
Radiology, Diagnostic Ultrasound2085U0001X——
Radiologic Technologist, Computed Tomography2471C3401X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (AL); Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (KS); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (NC); Part B Supplier - Clinic/Group Practice (ND); Part B Supplier - Clinic/Group Practice (NE); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (OK); Part B Supplier - Clinic/Group Practice (SC); Part B Supplier - Clinic/Group Practice (TN); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (UT); Part B Supplier - Clinic/Group Practice (VT); Part B Supplier - Clinic/Group Practice (WA); Part B Supplier - Clinic/Group Practice (WV)

Medicare sources and data years

Other diagnostic radiologists in Tallahassee

All 46 diagnostic radiologists in Tallahassee · All diagnostic radiologists in Florida