{
  "npi": "1396779237",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "B.S., RDMS, RT (R)",
    "authorized_official_first_name": "BRIAN",
    "authorized_official_last_name": "ELZIN",
    "authorized_official_middle_name": "F",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2038786768",
    "authorized_official_title_or_position": "Managing Member",
    "enumeration_date": "2006-07-10",
    "last_updated": "2016-08-31",
    "organization_name": "ADVANCED MOBILE IMAGING, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 416",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MILFORD",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "064600416",
      "state": "CT",
      "telephone_number": "203-878-6768"
    },
    {
      "address_1": "75 NEW HAVEN AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MILFORD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "203-878-6087",
      "postal_code": "064604854",
      "state": "CT",
      "telephone_number": "203-878-6768"
    }
  ],
  "taxonomies": [
    {
      "code": "2085U0001X",
      "desc": "Radiology, Diagnostic Ultrasound",
      "license": "81408",
      "primary": false,
      "state": "CT",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "2471B0102X",
      "desc": "Radiologic Technologist, Bone Densitometry",
      "license": "003259",
      "primary": false,
      "state": "CT",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "247200000X",
      "desc": "Technician, Other",
      "license": "003259",
      "primary": false,
      "state": "CT",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "335V00000X",
      "desc": "Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier",
      "license": "003259",
      "primary": true,
      "state": "CT",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Portable X-Ray Supplier",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "63",
        "medicare_type": "Portable X-Ray Supplier"
      }
    ]
  }
}