Aetna "Select Provider" Listing - High-Tech Radiology Jacksonville - January, 2013

Transcription

1 Aetna "Select Provider" Listing - High-Tech Radiology ALACHUA COUNTY Gainesville Doctors Imaging Group at Diagnostic Imaging Center , Svcs: CNM, PET Doctors Imaging Group, , Gainesville MRI Center 4340 West Newberry Road, Suite 104 Gainesville, FL Phone: / Fax: , Invision North Florida Outpatient Imaging Center , Northwest 9th Blvd. Phone: / Fax: , CT, PET , , Suite B Phone: / Fax: , PET BAKER COUNTY Macclenny Upright MRI , Ed Fraser Memorial Hospital 159 North 3rd Street Macclenny, FL A1 Imaging of , Kingsley Avenue Phone: / Fax: Diagnostic Health, 2128 Park Avenue Phone: / Fax: , , Profesional Center Drive Phone: / Fax: , CNM, CT, PET , Kingsley Avenue, Suite 108 Phone: / Fax: Southern Cardiac Nuclear Imaging, , Island Lane, Suite A, FL Phone: / Fax: Svcs: CNM A1 Imaging of Mandarin , Cardinal Point Drive, FL Phone: / Fax: Altec Diagnostic Imaging, Inc Spring Park Road Phone: / Fax: , CT , Ascent Diagnostic Imaging of, , Belfort Road Phone: / Fax: Svcs: CT, PET Baymeadows MRI 7999 Philips Hwy., Suite 311 Phone: / Fax: Svcs: MR , Comprehensive Medical Imaging- Northside , Dunn Avenue Phone: / Fax: Svcs: CT Eiber Radiology, Inc.() 5210 Belfort Road, Suite 130 Phone: / Fax: Svcs: CT, PET , Imaging Center at Forbes,LLC 2345 Forbes Street, FL Phone: / Fax: , CNM, CT , Imaging Center at Lakewood, LLC 2301 University Blvd. West, FL Phone: / Fax: , Beach Medical Imaging, Inc , Riverside Avenue, Suite 1, FL Phone: / Fax: , South 3rd Street, Suite 101, FL Phone: / Fax: , Kennerly Road, Suite 101 Phone: Upright MRI 4933 University Blvd. West , Precision Imaging Center 7860 Gate Pkwy., Suite 123 Phone: , PET , Premier Open MRI Center, L.C. 916 Dante Place, FL Phone: / Fax: , Radiology Consultants of MRI, Inc , Phillips Hwy., Suite 310 Phone: / Fax: Riverside Imaging Center 4171 Roosevelt Blvd., FL Phone: / Fax: , San Jose Imaging Center, LLC 9872 San Jose Blvd., FL Phone: / Fax: , CT , MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography 1 of 3

2 Aetna "Select Provider" Listing - High-Tech Radiology , Dunn Avenue Phone: / Fax: , CNM, CT, PET , Salisbury Road, Suite 100 Phone: / Fax: , Roosevelt Blvd., FL Phone: / Fax: , CNM, CT, PET , Fort Caroline Road, Suite B, FL Phone: / Fax: Southern Cardiac Nuclear Imaging, , Fort Caroline Road, FL Phone: / Fax: Svcs: CNM Specialty Imaging, LLC 3716 University Blvd. South, Suite 2 Phone: / Fax: , Beach Beaches Open MRI, LLC th Avenue, South Beach, FL Phone: , FLAGLER COUNTY Palm Coast Palm Coast Imaging Center , Pine Cone Drive, Suite 101 Palm Coast, FL Phone: / Fax: , CNM, CT, PET Town Center Imaging 21 Hospital Drive, Suite 130 Palm Coast, FL Phone: / Fax: , Belleview Belleview Imaging Center, , Southeast US Hwy. 441 Phone: / Fax: Svcs: MR, CNM, CT , Southeast Abshier Blvd. Phone: / Fax: , CNM, CT Dunnellon Citrus Diagnostic Center North Williams Street Dunnellon, FL Phone: / Fax: Svcs: MR , A1 Imaging of 301 Southeast 17th Street, Suite 102 Phone: / Fax: , Advanced Imaging Center Inc Southeast 17th Street, Bldg. 800 Phone: , Advanced Imaging of, Inc Southwest State Road 200, Suite 200, FL Phone: / Fax: , PET , Clinical PET of , Southwest 33rd Road, Suite 101, PET , Southwest 33rd Road, Suite 31, PET , Southwest 60th Avenue, FL Phone: / Fax: PET Services of Florida, 1541 Southwest 1st Avenue, Suite 101 Phone: Svcs: CT, PET , X-Ray & Imaging Center 2621 Southeast Lake Weir Road Phone: / Fax: Svcs: CT , NASSAU COUNTY Fernandina Beach Nassau Open MRI, LLC , South 14th Street, Suite Fernandina Beach, FL Phone: / Fax: PUTNAM COUNTY Palatka Doctors Imaging Group at Putnam Radiology Group , St. Johns Avenue Palatka, FL Phone: / Fax: SAINT JOHNS COUNTY St. Augustine A1 Imaging of St. Augustine , Southpark Blvd., Suite 210 Phone: / Fax: St. Augustine Imaging Center 190 Southpark Blvd., Suite 101 Phone: / Fax: , PET , Note(s): These procedures may require preauthorization. Aetna's radiology management vendors may have more current information that will replace the information contained within this List. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography 2 of 3

3 Aetna "Select Provider" Listing - High-Tech Radiology Effective January 1, 2012, Aetna requires all providers administering high-tech radiology services to be accredited by the American College of Radiology and/or the Intersocietal Accreditation Commission. Any provider who performs these services but is not accredited at the time of service may not be eligible for payment. Aetna s radiology management vendors will offer alternative accredited providers in accordance with these standards. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography 3 of 3

4 Aetna "Select Provider" Listing - Low-Tech Radiology ALACHUA COUNTY Gainesville Doctors Imaging Group at Diagnostic Imaging Center , Doctors Imaging Group Vascular and Interventional Physicians , Northwest 9th Blvd. Phone: / Fax: Svcs: FL, US, M Doctors Imaging Group,, FL, US, M , Gainesville Women's Center for Radiology , Northwest 11th Place Phone: / Fax: , US, S, BD, M BAKER COUNTY Macclenny Upright MRI , Ed Fraser Memorial Hospital 159 North 3rd Street Macclenny, FL 32063, US Diagnostic Health, , Park Avenue Phone: / Fax: , FL, US, S, M , Profesional Center Drive Phone: / Fax: , Kingsley Avenue, Suite 108 Phone: / Fax: , FL, US, M Advanced Diagnostic Group , Southpoint Pkwy., Suite 401 Phone: / Fax: Altec Diagnostic Imaging, Inc , Spring Park Road Phone: / Fax: Imaging Center at Forbes,LLC , Forbes Street, FL Phone: / Fax: Imaging Center at Lakewood, LLC , University Blvd. West, FL Phone: / Fax: Beach Medical Imaging, Inc , Riverside Avenue, Suite 1, FL Phone: / Fax: , South 3rd Street, Suite 101, FL Phone: / Fax: , BD , Kennerly Road, Suite 101 Phone: Upright MRI , University Blvd. West, US Monument/9A Imaging Center , Monument Road, Suite 101, FL Phone: Precision Imaging Center , Gate Pkwy., Suite 123 Phone: , US, S, BD, M San Jose Imaging Center, LLC , San Jose Blvd., FL Phone: / Fax: , US, S, M , Dunn Avenue Phone: / Fax: , Salisbury Road, Suite 100 Phone: / Fax: , Roosevelt Blvd., FL Phone: / Fax: , Fort Caroline Road, Suite B, FL Phone: / Fax: Specialty Imaging, LLC , University Blvd. South, Suite 2 Phone: / Fax: , US, M Beach Beaches Open MRI, LLC , th Avenue, South Beach, FL Phone: , BD FLAGLER COUNTY Palm Coast Palm Coast Imaging Center , Pine Cone Drive, Suite 101 Palm Coast, FL Phone: / Fax: Town Center Imaging , Hospital Drive, Suite 130 Palm Coast, FL Phone: / Fax: , US, S, BD, M Belleview Belleview Imaging Center, , Southeast US Hwy. 441 Phone: / Fax: , US X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography 1 of 2

5 Aetna "Select Provider" Listing - Low-Tech Radiology , Southeast Abshier Blvd. Phone: / Fax: , US, S, BD Dunnellon Citrus Diagnostic Center North Williams Street Dunnellon, FL Phone: / Fax: , US , Advanced Imaging Center Inc , Southeast 17th Street, Bldg. 800 Phone: , Southeast 17th Street Phone: , FL, US, M Advanced Imaging of, Inc Southwest State Road 200, Suite 200, FL Phone: / Fax: , US, S, BD, M , Clinical PET of , Southwest 33rd Road, Suite 101, US, M , Southwest 33rd Road, Suite 31, US, M , Southwest 60th Avenue, FL Phone: / Fax: , US, M PUTNAM COUNTY Palatka Doctors Imaging Group at Putnam Radiology Group , St. Johns Avenue Palatka, FL Phone: / Fax: SAINT JOHNS COUNTY Raina Imaging, Inc , State Road 13 North, Suite 263, FL Phone: / Fax: , US St. Augustine St. Augustine Imaging Center 190 Southpark Blvd., Suite 101 Phone: / Fax: , X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography 2 of 2

6 Aetna "Select Provider" Listing - Ambulatory Surgery ALACHUA COUNTY Gainesville Laser and Outpatient Surgery Center, , Northwest 11th Place Phone: / Fax: Svcs: GEN, LT, OPT, ORP, UR, Pain Management, Plastic North Florida Surgical Pavillion , Northwest 10th Place Phone: Svcs: GEN, INF, OPT, ORP, UR, ENT, Gynecology, Neurosurgery, Pain Management, Plastic Surgery, Podiatry Fleming Island Surgery Center, LLC , B Eagle Harbor Pkwy., FL Phone: / Fax: Svcs: GEN, EN, INF, LT, OPT, ORP, UR, ENT, Plastic, Podiatry Surgery Center - HCA Affiliate , Professional Center Drive Phone: / Fax: Svcs: GEN, EN, INF, LT, OPT, ORP, UR Center One Surgery Center , Centurion Pkwy. North, Suite 101 Phone: / Fax: Svcs: ORP, UR, Pain Management, ENT, Plastic, Podiatry Healthsouth Medical Partners Surgery Center , Emerson Street, FL Phone: / Fax: Svcs: GEN, EN, OPT, ORP, UR, ENT Surgery Center - HCA Affiliate , A. C. Skinner Pkwy. Phone: / Fax: Svcs: GEN, EN, INF, LT, OPT, ORP, BA, ENT, Plastic, Podiatry Parkside Surgery Center - HCA Affiliate , Park Street, FL Phone: Svcs: GEN, EN, INF, LT, ORP, BA, UR, Podiatry/ENT Plaza Surgery Center-HCA Affiliate , Kennerly Road Phone: / Fax: Svcs: GEN, EN, INF, LT, OPT, ORP, UR, ENT, Plastic, Podiatry Southpoint Surgery Center, LLC , South Point Pkwy. Phone: / Fax: Svcs: GEN, INF, OPT, ORP, BA, Pain Management, ENT, Plastic Beach Beach Surgery Center, L.P , South 3rd Street, Suite 200 Beach, FL Phone: / Fax: Svcs: GEN, EN, INF, LT, OPT, ORP, BA, UR, Podiatry Mid-Florida Endoscopy and Surgery Center, LLC , Southwest 18th Court, Suite 200 Phone: / Fax: Svcs: EN, OPT Surgery Center Of , Southwest 34th Street Phone: / Fax: Svcs: GEN, EN, INF, ORP, UR, Pain Management/ENT SAINT JOHNS COUNTY St. Augustine St. Augustine Surgery Center, , Southpark Blvd. Phone: Svcs: GEN, LT, OPT, ORP, UR, Pain Management, ENT, Podiatry Note(s): Some ambulatory procedures require the physician to notify Aetna prior to performing services (e.g., colonoscopy and other scope procedures). These procedures were not used to determine this listing. GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 1 of 1

7 Aetna "Select Provider" Listing - Sleep Studies Fleming Island Florida Center of Sleep Medicine, Inc , Eagle Harbor Pkwy., Suite A Fleming Island, FL / Fax: Florida Center of Sleep Medicine, Inc , Kingsley Avenue, Building 2 / Fax: , Eagle Harbor Pkwy., Suite A, FL / Fax: Sleep Center LLC 1542 Kingsley Avenue, Suite 138 Phone: / Fax: , Atlantic Beach Flagler Diagnostic & Sleep Disorder Center , Mayport Road, Suite 2 Atlantic Beach, FL Phone: / Fax: American Sleep Medicine 7900 Belfort Pkwy., Suite 300 Phone: , Florida Center of Sleep Medicine, Inc , th Avenue South, Suite 110, FL , University Blvd. South, Suite , North Lee Street, Suite 204, FL Phone: / Fax: , Hampton Professional Park 7807 Baymeadows Road East, Suite 202 / Fax: , San Jose Blvd., Building 2, Suite 7, FL , San Jose Blvd., Bldg. 2 Suite 7, FL North Florida Sleep Solutions, Inc North Main Street, Suite 304 Phone: / Fax: , Sleep Center LLC 4301 Confederate Pt Road, apt 186, FL Phone: , Sleep Telemedicine Services , Dunn Avenue, Suite 8 Phone: / Fax: , Atlantic Blvd., Suite 100, FL Phone: / Fax: Welcome Homecare Sleep Disorder Clinics , Regency Square Blvd., FL Phone: / Fax: FLAGLER COUNTY Bunnell Flagler Diagnostic & Sleep Disorder Center , East Moody Blvd., Building 1, Suite 104 Bunnell, FL Phone: / Fax: Palm Coast Advanced Sleep and Respiratory Institute, PA , Leanni Way, Unit D-1 and D-2 Palm Coast, FL Phone: / Fax: Florida Sleep Solutions, Inc , Southwest State Road, Bldg. 2000, Suite 200, FL Phone: of 1