Unknown Individual – Diagnostic Radiology Physician, NPI 1578563276
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
2355 HIGHWAY 36 W STE 100
ROSEVILLE, MN 551133905
Phone: (651) 292-2000
Type: Mailing
4801, West 81st Street, Bloomington, Hennepin County, Minnesota, 55437, United States
BLOOMINGTON, MN 554371111
Phone: (952) 837-9700
Fax: (952) 837-9701
Type: Mailing
108, West 81st Street, Bloomington, Hennepin County, Minnesota, 55420, United States
BLOOMINGTON, MN 554371111
Phone: (952) 837-9700
Fax: (952) 837-9701
Type: Location
4801 W 81st St Ste 108
Bloomington, MN 554371111
Phone: (952) 837-9700
Fax: (952) 837-9701
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 $42.
Total Amount is formed as General ($42) + Research ($0) + Ownership ($0) = $42.
Last reported payment date: 2023-03-15 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($42).
Total Amount
$42
General + Research + Ownership
Payments
1
Total payment records
General Amount
$42
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boehringer Ingelheim Pharmaceuticals, Inc. | $42 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1,196 | 12 | $0 |
| 77067 | Screening mammography | 52 | 52 | $0 |
| 77063 | Screening 3d breast mammography | 46 | 46 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 38 | 37 | $0 |
| 71260 | Ct scan of chest with contrast | 35 | 34 | $0 |
Insurance plans in this area (ZIP 55113)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | WI | |
| - | MN | |
| - | MN | |
| - | MN | |
| Physician Assistant | MN | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | MN | |
| - | MN |
Reviews
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