MEDICARE: RIVERSIDE RADIOLOGY AND INTERVENTIONAL ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093718496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSIDE RADIOLOGY AND INTERVENTIONAL ASSOCIATES INC

Provider Business Mailing Address
First Line	:	100 E CAMPUS VIEW BLVD STE 160
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235-8634
Country	:	US
Telephone Number	:	614-396-4750
Fax Number	:	614-396-4742

Provider Business Practice Location Address
First Line	:	3525 OLENTANGY RIVER RD
Second Line	:	STE 5360
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3937
Country	:	US
Telephone Number	:	614-340-7747
Fax Number	:	614-340-7742

Authorized Official
Title or Position	:	CFO
Name	:	JIMMY DADO
Credential	:
Telephone Number	:	614-325-8899

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	11/21/2025

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