DR. GREGORY D PENNOCK (MD) – Cardiovascular Disease Physician, NPI 1700889607
Cardiovascular Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. GREGORY D PENNOCK (MD)
West Kootenai Health Way, Coeur d'Alene, Kootenai County, Idaho, 83815, United States
COEUR D ALENE, ID 838146051
Phone: (208) 625-5085
Fax: (208) 625-5731
Type: Mailing
423 N THIRD AVE STE 335
SANDPOINT, ID 83864
Phone: (208) 265-7070
Fax: (208) 265-7071
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: 2018-05-17
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 |
|---|---|---|---|---|
| I20180517001804 | I | Cardiovascular Disease (Cardiology) | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83814)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | AZ | 93280 | Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report | 120 | 56 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ID | |
| Orthopedic Surgery | ID | |
| Interventional Cardiology | WA | |
| - | ID | |
| - | WA | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | ID | |
| - | WA | |
| - | ID | |
| - | OR | |
| Pulmonary Disease, Critical Care (Intensivists) | ID |
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