DR. LARRY THOMAS JR. NICKELL (MD) – Diagnostic Radiology Physician, NPI 1669797346
Diagnostic Radiology Physician
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NPPES metrics only — not quality of care.
933 DIAGNOSTIC RADIOLOGY in CO
Provider Addresses for DR. LARRY THOMAS JR. NICKELL (MD)
2222 N Nevada Ave
Colorado Springs, CO 809076819
Phone: (719) 593-1799
Fax: (719) 265-3794
Type: Location
315 SOUTH MANNING BLVD
ALBANY, NY 122086819
Phone: (518) 525-1401
Type: Location
PO BOX 14890
ALBANY, NY 122124890
Phone: (518) 525-5634
Type: Mailing
PENRAD Imaging, 1390, Kelly Johnson Boulevard, Colorado Springs, El Paso County, Colorado, 80920, United States
COLORADO SPRINGS, CO 809203908
Phone: (719) 593-1799
Fax: (719) 265-3794
Type: Mailing
Penrose Hospital, 2222, North Nevada Avenue, Old North End, Colorado Springs, El Paso County, Colorado, 80907, United States
COLORADO SPRINGS, CO 809076819
Phone: (719) 593-1799
Fax: (719) 265-3794
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: 2016-08-16
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 |
|---|---|---|---|---|
| I20160816002509 | I | Diagnostic Radiology | CO | 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 |
|---|---|---|---|---|
| 77067 | Screening mammography | 459 | 459 | $0 |
| 71045 | X-ray of chest, 1 view | 444 | 359 | $0 |
| 77063 | Screening 3d breast mammography | 433 | 433 | $0 |
| 71046 | X-ray of chest, 2 views | 302 | 277 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 214 | 201 | $0 |
Insurance plans in this area (ZIP 80907)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | CO | 71250 | CT scan chest | 13 | 13 |
| DIAGNOSTIC RADIOLOGY | CO | 74177 | CT scan of abdomen and pelvis with contrast | 33 | 32 |
| DIAGNOSTIC RADIOLOGY | CO | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 13 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | CA | |
| - | CO | |
| Diagnostic Radiology | CO | |
| Diagnostic Radiology, Interventional Radiology | CO | |
| Interventional Radiology, Nuclear Medicine, Diagnostic Radiology | CO | |
| Diagnostic Radiology, Interventional Radiology, Nuclear Medicine | CO | |
| Diagnostic Radiology, Interventional Radiology, Nuclear Medicine | CO | |
| Diagnostic Radiology | CO | |
| Interventional Radiology, Diagnostic Radiology, Nuclear Medicine | CO | |
| Diagnostic Radiology | AR |
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