JEREMY EUGENE WIDENER (DO) – Diagnostic Radiology Physician, NPI 1215557178
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
384 DIAGNOSTIC RADIOLOGY in OK
Provider Addresses for JEREMY EUGENE WIDENER (DO)
1000 N LEE AVE RM 1980
OKLAHOMA CITY, OK 731021036
Phone: (405) 272-8437
Fax: (405) 231-3007
Type: Mailing
1200 EVERETT DR
OKLAHOMA CITY, OK 731045047
Phone: (405) 271-5125
Type: Mailing
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 $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2023-07-29 • Largest payer in this snapshot: Inari Medical, Inc. ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $19 |
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: 2025-06-02
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 |
|---|---|---|---|---|
| I20250602001736 | I | Diagnostic Radiology | OK | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Radiology, Diagnostic Radiology | LA | |
| Diagnostic Radiology | TX | |
| Diagnostic Radiology | GA | |
| Diagnostic Radiology | TX | |
| - | TX | |
| Interventional Cardiology, Diagnostic Radiology | TX | |
| Diagnostic Radiology | TX | |
| - | TX | |
| Diagnostic Radiology | TX | |
| Interventional Radiology, Diagnostic Radiology | PA |
Reviews
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