Breast Diagnostic Center, LLC
NPI 1790748499ActiveOrganization· Radiology, Diagnostic Radiology· Fort Wayne, IN
Radiology, Diagnostic Radiology in Fort Wayne, Indiana, registered in NPPES in April 2006. The authorized official on file is Adam M. Gregory, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1790748499 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 11, 2006 |
| Last updated in NPPES | Oct 17, 2026 |
| Certified by provider | Oct 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Diagnostic Radiology Primary | 2085R0202X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN); Part B Supplier - Clinic/Group Practice (MO) |
|---|
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