DR. MATTHEW SCOTT LIDSTROM (MD) – Diagnostic Radiology Physician, NPI 1447512348
Diagnostic Radiology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
195 DIAGNOSTIC RADIOLOGY in ID
Provider Addresses for DR. MATTHEW SCOTT LIDSTROM (MD)
25 Jacobs Gulch Rd
Kellogg, ID 838372023
Phone: (208) 784-1221
Fax: (208) 784-0961
Type: Location
2003 Kootenai Health Way
Coeur D Alene, ID 838146051
Phone: (208) 625-6360
Fax: (208) 625-6361
Type: Location
700 W IRONWOOD DR STE 175
COEUR D ALENE, ID 838144401
Phone: (208) 625-6309
Fax: (208) 625-6310
Type: Mailing
842 E MAIN ST
MEDFORD, OR 975047134
Phone: (541) 773-2493
Fax: (541) 779-3027
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2020-04-01
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 |
|---|---|---|---|---|
| I20200401002280 | 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 |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 293 | 253 | $0 |
| 70450 | Ct scan head or brain without contrast | 248 | 221 | $0 |
| A9577 | Injection, gadobenate dimeglumine (multihance), per ml | 245 | 13 | $0 |
| 71046 | X-ray of chest, 2 views | 238 | 204 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 229 | 221 | $0 |
Insurance plans in this area (ZIP 83837)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | ID | |
| Diagnostic Radiology | ID | |
| Emergency Medicine | ID | |
| Clinical Social Worker | ID | |
| Internal Medicine | ID | |
| - | ID | |
| Family Practice | ID | |
| Nurse Practitioner | ID | |
| Interventional Radiology, Nuclear Medicine, Diagnostic Radiology | CO | |
| Diagnostic Radiology | ID |
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.