DR. LOUBA RODENKO LAURIE (MD) – Diagnostic Radiology Physician, NPI 1124067798
Diagnostic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
2,121 DIAGNOSTIC RADIOLOGY in IL
Provider Addresses for DR. LOUBA RODENKO LAURIE (MD)
PO BOX 7412011
CHICAGO, IL 606742011
Phone: (618) 257-5613
Fax: (314) 454-4641
Type: Mailing
4500 MEMORIAL DR
DEPT RADIOLOGY
BELLEVILLE, IL 622265360
Phone: (618) 257-5613
Fax: (314) 454-4641
Type: Location
712, North Washington Avenue, Dallas, TX, Dallas, Dallas County, Texas, 75204, United States
SUITE 101
DALLAS, TX 752461619
Phone: (214) 826-8822
Fax: (214) 826-9792
Type: Mailing
Baylor University Medical Center, 3500, Gaston Avenue, Old East Dallas, Dallas, TX, Dallas, Dallas County, Texas, 75246, United States
DALLAS, TX 75246
Phone: (214) 826-8822
Fax: (214) 826-9792
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $72.
Total Amount is formed as General ($72) + Research ($0) + Ownership ($0) = $72.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Medtronic, Inc. ($72).
Total Amount
$72
General + Research + Ownership
Payments
1
Total payment records
General Amount
$72
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $72 |
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: 2025-10-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20031118000724 | I | Diagnostic Radiology | TX | TBD |
| I20180322002002 | I | Diagnostic Radiology | IL | TBD |
| I20180829001970 | I | Diagnostic Radiology | IN | TBD |
| I20190417000725 | I | Diagnostic Radiology | MO | TBD |
| I20251030005253 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 2,281 | 2,281 | $0 |
| 77063 | Screening 3d breast mammography | 2,110 | 2,109 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 353 | 322 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 299 | 268 | $0 |
| 77066 | Diagnostic mammography of both breasts | 219 | 217 | $0 |
Insurance plans in this area (ZIP 60674)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MO | |
| - | FL | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | NH | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | IL | |
| Diagnostic Radiology | IL |
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