DR. RODERICK JACK WILLMORE (M.D.) – Diagnostic Radiology Physician, NPI 1346538253
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
195 DIAGNOSTIC RADIOLOGY in ID
Provider Addresses for DR. RODERICK JACK WILLMORE (M.D.)
2265 E SUNNYSIDE RD
IDAHO FALLS, ID 834047598
Phone: (208) 542-5000
Fax: (208) 542-5151
Type: Mailing
3100 CHANNING WAY
IDAHO FALLS, ID 834047533
Phone: (208) 529-6111
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $24.
Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.
Last reported payment date: 2024-10-09 • Largest payer in this snapshot: GE HEALTHCARE ($24).
Total Amount
$24
General + Research + Ownership
Payments
1
Total payment records
General Amount
$24
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GE HEALTHCARE | $24 |
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: 2017-06-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20160721002408 | I | Diagnostic Radiology | UT | TBD |
| I20170602000855 | I | Diagnostic Radiology | WY | TBD |
| I20170602000883 | I | Diagnostic Radiology | MT | TBD |
| I20170602000916 | I | Diagnostic Radiology | ID | 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 | 2,460 | 26 | $0 |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 1,480 | 1,472 | $0 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1,275 | 12 | $0 |
| 77067 | Screening mammography | 449 | 442 | $0 |
| 77063 | Screening 3d breast mammography | 443 | 436 | $0 |
Insurance plans in this area (ZIP 83404)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology, Interventional Radiology | ID | |
| Interventional Radiology | ID | |
| Diagnostic Radiology | TX | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | TX |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.