1508869314 NPI number — OPEN MRI OF IOWA, L.L.C.

Table of content: JUAN MIGUEL LEE MD (NPI 1235469784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508869314 NPI number — OPEN MRI OF IOWA, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN MRI OF IOWA, L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508869314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7601 OFFICE PLAZA DR N
Provider Second Line Business Practice Location Address:
STE 115
Provider Business Practice Location Address City Name:
WEST DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50266-2338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-222-0550
Provider Business Practice Location Address Fax Number:
515-222-0544
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6446300 . This is a "COVENTRY HEALTHCARE OF IA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 16-00340 . This is a "UNITED HEALTHCARE MIDLAND" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: F246150 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: A-80808 . This is a "MULTIPLAN" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 17063 . This is a "MEDFOCUS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 44997 . This is a "BCBS OF IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0180133 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1126226 . This is a "FIRST HEALTH NETWORK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 44997 . This is a "WELLMARK BCBS OF IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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