MRUDULA PENTA (MD) – Diagnostic Radiology Physician, NPI 1568670917
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,800 DIAGNOSTIC RADIOLOGY in CA
Provider Addresses for MRUDULA PENTA (MD)
300 PASTEUR DR RM S047
STANFORD, CA 943052200
Phone:
Type: Mailing
220 COMPASS POINT DRIVE
ST CHARLES, MO 63301
Phone: (636) 947-4480
Fax: (636) 947-9860
Type: Mailing
300 FIRST CAPITAL DRIVE
ST CHARLES, MO 63301
Phone: (636) 947-5444
Fax: (636) 947-5259
Type: Location
100 S San Mateo Dr
San Mateo, CA 944013805
Phone: (650) 696-4515
Fax: (650) 696-4637
Type: Location
222 W 39th Ave
San Mateo, CA 944034364
Phone: (650) 573-2681
Fax: (650) 573-2122
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160406001016 | I | Diagnostic Radiology | CA | TBD |
| I20250729004705 | I | Diagnostic Radiology | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 70450 | Ct scan head or brain without contrast | 418 | 394 | $0 |
| 70553 | Mri scan of brain before and after contrast | 404 | 390 | $0 |
| 70551 | Mri scan of brain without contrast | 161 | 159 | $0 |
| 70544 | Mri scan of blood vessels of head without contrast | 142 | 140 | $0 |
| 72148 | Mri scan of lower spinal canal without contrast | 121 | 121 | $0 |
Insurance plans in this area (ZIP 94305)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO | |
| - | MO | |
| Interventional Pain Management, Anesthesiology | MO |
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