Tellica Imaging, LLC
NPI 1518727734ActiveOrganization· Physiological Laboratory· Spanish Fork, UT
Physiological Laboratory in Spanish Fork, Utah, registered in NPPES in March 2024. The authorized official on file is Brad Isaacson, President. Enrolled in Medicare as part b supplier - independent diagnostic testing facility (idtf).
Overview
| NPI | 1518727734 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 22, 2024 |
| Last updated in NPPES | Aug 27, 2025 |
| Certified by provider | Aug 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physiological Laboratory Primary | 293D00000X | — | — |
| Clinic/Center, Radiology | 261QR0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Independent Diagnostic Testing Facility (Idtf) (UT) |
|---|