DR. AMANDA ELIZABETH LACKEY (MD) – Diagnostic Radiology Physician, NPI 1194041855
Diagnostic Radiology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,218 DIAGNOSTIC RADIOLOGY in MO
Provider Addresses for DR. AMANDA ELIZABETH LACKEY (MD)
PO BOX 60352
SAINT LOUIS, MO 631600352
Phone: (314) 362-7200
Fax: (314) 747-4189
Type: Mailing
510 S KINGSHIGHWAY BLVD
DEPT RADIOLOGY
SAINT LOUIS, MO 631101016
Phone: (314) 362-7200
Fax: (314) 747-4189
Type: Location
2055 S FREMONT AVE
SUITE 120
SPRINGFIELD, MO 658042206
Phone: (417) 820-2500
Type: Mailing
1102 W 32nd St
Joplin, MO 648043503
Phone: (417) 347-6611
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $40.
Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.
Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($40).
Total Amount
$40
General + Research + Ownership
Payments
1
Total payment records
General Amount
$40
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Hologic Sales and Service, LLC | $40 |
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: 2023-06-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20160811002023 | I | Diagnostic Radiology | MO | TBD |
| I20230613002398 | 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 | 520 | 519 | $0 |
| 77063 | Screening 3d breast mammography | 479 | 479 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 171 | 169 | $0 |
| 77065 | Diagnostic mammography of 1 breast | 139 | 135 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 102 | 100 | $0 |
Insurance plans in this area (ZIP 63160)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | MO | 74177 | CT scan of abdomen and pelvis with contrast | 43 | 43 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.