MEDICARE: OPEN MRI OF IOWA, L.L.C.

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
2	261QR0200X	Radiology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6446300	OTHER	IA	COVENTRY HEALTHCARE OF IA
2	16-00340	OTHER	IA	UNITED HEALTHCARE MIDLAND
3	F246150	OTHER	IA	MIDLANDS CHOICE
4	A-80808	OTHER	IA	MULTIPLAN
5	17063	OTHER	IA	MEDFOCUS
6	44997	OTHER	IA	BCBS OF IOWA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	1126226	OTHER	IA	FIRST HEALTH NETWORK
9	44997	OTHER	IA	WELLMARK BCBS OF IOWA

General Provider Information

NPI Number	:	1508869314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN MRI OF IOWA, L.L.C.

Provider Business Mailing Address
First Line	:	100 PARAGON DR
Second Line	:	STE 200
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1718
Country	:	US
Telephone Number	:	201-573-8080
Fax Number	:	201-775-4306

Provider Business Practice Location Address
First Line	:	7601 OFFICE PLAZA DR N
Second Line	:	STE 115
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-2338
Country	:	US
Telephone Number	:	515-222-0550
Fax Number	:	515-222-0544

Authorized Official
Title or Position	:	CEO
Name	:	LAWRENCE M. BUCHWALTER
Credential	:
Telephone Number	:	201-573-8080

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	09/11/2025

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