DR. WAYNE KENNETH MANNESS (MD) – Diagnostic Radiology Physician, NPI 1710936497
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,121 DIAGNOSTIC RADIOLOGY in IL
Provider Addresses for DR. WAYNE KENNETH MANNESS (MD)
530 NE GLEN OAK AVE
PEORIA, IL 616370914
Phone: (309) 655-2000
Type: Location
1709 Jumer Dr
Suite B
Bloomington, IL 617040914
Phone: (309) 665-0640
Fax: (309) 665-0657
Type: Location
111 OAKWOOD RD
EAST PEORIA, IL 616111853
Phone: (309) 740-4272
Type: Mailing
Jumer Drive, Bloomington, McLean County, Illinois, 61704, United States
SUITE B
BLOOMINGTON, IL 617040914
Phone: (309) 665-0640
Fax: (309) 665-0657
Type: Mailing
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: 2004-06-16
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 |
|---|---|---|---|---|
| I20040616000031 | I | Diagnostic Radiology | IL | 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 |
|---|---|---|---|---|
| 70450 | Ct scan head or brain without contrast | 728 | 683 | $0 |
| 70498 | Ct scan of blood vessels of neck with contrast | 290 | 285 | $0 |
| 70496 | Ct scan of blood vessels of head with contrast | 276 | 270 | $0 |
| 72125 | Ct scan of upper spine without contrast | 273 | 266 | $0 |
| 72148 | Mri scan of lower spinal canal without contrast | 155 | 155 | $0 |
Insurance plans in this area (ZIP 61637)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | FL | |
| Diagnostic Radiology | IL | |
| Physician Assistant | IL | |
| - | IL | |
| Diagnostic Radiology | FL | |
| - | IL | |
| Diagnostic Radiology | IL | |
| - | IL | |
| - | IL | |
| Diagnostic Radiology | IL |
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