ST JUDE RADIOLOGY MEDICAL GROUP INC
NPI 1649349705
Radiology - Diagnostic Radiology in Fullerton, CA
About St Jude Radiology Medical Group Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ST JUDE RADIOLOGY MEDICAL GROUP INC (NPI 1649349705) is a healthcare organization registered as a diagnostic radiology in Fullerton, California and active in the NPI registry since November 2006. The organization lists Renee Nicole Davison, Administrative Assistant, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
St Jude Radiology Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
120Medicare enrollment records show 120 clinicians reassign Medicare billing to St Jude Radiology Medical Group Inc, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 11 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 120Fullerton, CA 92835
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is St Jude Radiology Medical Group Inc's NPI number?
The NPI number for St Jude Radiology Medical Group Inc is 1649349705. It was assigned to this organization in the NPPES registry on November 6, 2006.
Where is St Jude Radiology Medical Group Inc located?
St Jude Radiology Medical Group Inc is located at 101 E Valencia Mesa Dr, Fullerton, CA 92835. The listed phone number is (714) 992-3000.
What is St Jude Radiology Medical Group Inc's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is St Jude Radiology Medical Group Inc enrolled in Medicare?
Yes. St Jude Radiology Medical Group Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through St Jude Radiology Medical Group Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 120 clinicians in 2 Medicare specialties reassign their Medicare billing to St Jude Radiology Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (117) and Interventional Radiology (3). Of these, 7 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for St Jude Radiology Medical Group Inc was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# St Jude Radiology Medical Group Inc · NPI 1649349705
Diagnostic Radiology organization in Fullerton, California. Organization record, active in the CMS NPPES registry since November 6, 2006.
## Identity
- **NPI:** 1649349705 (Entity type: Organization)
- **Enumerated:** November 6, 2006
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **Organization subpart:** No
- **Authorized official:** Renee Davison, ADMINISTRATIVE ASSISTANT
## Practice location
- **Address:** 101 E VALENCIA MESA DR, Fullerton, CA 92835
- **Phone:** (714) 992-3000 · **Fax:** (714) 992-3928
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 120 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (117), Interventional Radiology (3); 7 practice at this address and 11 within 10 miles; [full list](https://npiprofile.com/npi/1649349705/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 4, 2025
- **Other identifiers:** Medicaid ZZZ49329Z (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1649349705) · Data from the CMS NPPES public registry.