DR. RUTH L POLAN (MD) – Diagnostic Radiology Physician, NPI 1629048350
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,800 DIAGNOSTIC RADIOLOGY in CA
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Provider Addresses for DR. RUTH L POLAN (MD)
Christopher Costanzo MD, 2190, Lynn Road, Thousand Oaks, Ventura County, California, 91360, United States
SUITE 220
THOUSAND OAKS, CA 913601980
Phone: (805) 495-8050
Fax: (805) 496-2160
Type: Mailing
227, West Janss Road, Thousand Oaks, Ventura County, California, 91360, United States
SUITE 150
THOUSAND OAKS, CA 913601848
Phone: (805) 496-7755
Fax: (805) 379-3913
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.
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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: 2008-11-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20081110000174 | I | Diagnostic Radiology | CA | 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 |
|---|---|---|---|---|
| A9585 | Injection, gadobutrol, 0.1 ml | 1,855 | 23 | $0 |
| 77067 | Screening mammography | 1,376 | 1,376 | $0 |
| 77063 | Screening 3d breast mammography | 1,375 | 1,375 | $0 |
| 71046 | X-ray of chest, 2 views | 665 | 580 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 386 | 367 | $0 |
Insurance plans in this area (ZIP 91360)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | CA | 71250 | CT scan chest | 78 | 77 |
| DIAGNOSTIC RADIOLOGY | CA | 73630 | X-ray of foot, minimum of 3 views | 12 | 12 |
| DIAGNOSTIC RADIOLOGY | CA | 74177 | CT scan of abdomen and pelvis with contrast | 83 | 82 |
| DIAGNOSTIC RADIOLOGY | CA | 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 15 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| - | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA |
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