MATTHEW A KETELAAR (MD) – Diagnostic Radiology Physician, NPI 1336109180
Diagnostic Radiology Physician
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NPPES metrics only — not quality of care.
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Provider Addresses for MATTHEW A KETELAAR (MD)
1970, East 53rd Street, Davenport, Scott County, Iowa, 52807, United States
DAVENPORT, IA 528072710
Phone: (563) 359-3949
Mailing address matches the actual address.
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.
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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: 2011-12-01
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 |
|---|---|---|---|---|
| I20111201000389 | 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 |
|---|---|---|---|---|
| 77067 | Screening mammography | 706 | 706 | $0 |
| 77063 | Screening 3d breast mammography | 703 | 703 | $0 |
| 71046 | X-ray of chest, 2 views | 142 | 141 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 110 | 109 | $0 |
| 71045 | X-ray of chest, 1 view | 107 | 104 | $0 |
Insurance plans in this area (ZIP 52807)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | IA | 73562 | X-ray of knee, 3 views | 67 | 55 |
| DIAGNOSTIC RADIOLOGY | IA | 74177 | CT scan of abdomen and pelvis with contrast | 121 | 120 |
| DIAGNOSTIC RADIOLOGY | IA | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 39 | 38 |
| DIAGNOSTIC RADIOLOGY | IA | 93922 | Ultrasound study of arteries of both arms and legs | 18 | 18 |
| DIAGNOSTIC RADIOLOGY | IA | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 54 | 51 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology, Interventional Radiology | IA | |
| - | IA | |
| Diagnostic Radiology | IA | |
| Diagnostic Radiology | IA | |
| Diagnostic Radiology | IA | |
| Diagnostic Radiology, Interventional Radiology, Nuclear Medicine | IA | |
| Diagnostic Radiology | IA | |
| Diagnostic Radiology | IA | |
| - | IA | |
| Diagnostic Radiology | IA |
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