BRIAN A KRIVISKY (MD) – Diagnostic Radiology Physician, NPI 1043265952
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BRIAN A KRIVISKY (MD)
3660, Broadway, Tropical Trailer Park, Fort Myers, Lee County, Florida, 33901, United States
FORT MYERS, FL 339018005
Phone: (239) 936-2316
Type: Mailing
14551 HOPE CENTER LOOP STE 100
FORT MYERS, FL 339124705
Phone: (239) 936-2316
Fax: (239) 936-3099
Type: Location
3680, Broadway, Fort Myers, Lee County, Florida, 33901, United States
FORT MYERS, FL 339018005
Phone: (239) 936-2316
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: 2004-11-10
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 |
|---|---|---|---|---|
| I20041110000316 | I | Diagnostic Radiology | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33901)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | FL | 71010 | X-ray of chest, 1 view, front | 198 | 165 |
| DIAGNOSTIC RADIOLOGY | FL | 74177 | CT scan of abdomen and pelvis with contrast | 72 | 71 |
| DIAGNOSTIC RADIOLOGY | FL | 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 112 | 109 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | FL | |
| Diagnostic Radiology | FL | |
| Diagnostic Radiology | FL | |
| Diagnostic Radiology | FL | |
| Diagnostic Radiology, Interventional Radiology | FL | |
| Diagnostic Radiology | FL | |
| - | FL | |
| Diagnostic Radiology | FL | |
| Diagnostic Radiology | MO | |
| Diagnostic Radiology | MI |
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