DR. BRANT DAVID WOMMACK (MD) – Diagnostic Radiology Physician, NPI 1023164613
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DIAGNOSTIC RADIOLOGY in OR
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Provider Addresses for DR. BRANT DAVID WOMMACK (MD)
1460, Northeast Medical Center Drive, Bend, Deschutes County, Oregon, 97701, United States
BEND, OR 977016061
Phone: (541) 382-6633
Fax: (541) 382-2719
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.
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: 2010-10-25
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 |
|---|---|---|---|---|
| I20101025001081 | I | Diagnostic Radiology | OR | 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 |
|---|---|---|---|---|
| A9585 | Injection, gadobutrol, 0.1 ml | 1,550 | 18 | $0 |
| 77067 | Screening mammography | 1,026 | 627 | $0 |
| 77063 | Screening 3d breast mammography | 1,019 | 620 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 286 | 169 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 207 | 123 | $0 |
Insurance plans in this area (ZIP 97701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | OR | 71010 | X-ray of chest, 1 view, front | 297 | 256 |
| DIAGNOSTIC RADIOLOGY | OR | 73562 | X-ray of knee, 3 views | 42 | 37 |
| DIAGNOSTIC RADIOLOGY | OR | 73630 | X-ray of foot, minimum of 3 views | 25 | 23 |
| DIAGNOSTIC RADIOLOGY | OR | 74177 | CT scan of abdomen and pelvis with contrast | 88 | 87 |
| DIAGNOSTIC RADIOLOGY | OR | 77012 | Radiological supervision and interpretation of CT guidance for needle insertion | 19 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| Orthopedic Surgery | NM | |
| Family Practice | OR | |
| Nurse Practitioner | OR | |
| Hand Surgery | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| General Surgery | OR | |
| - | OR |
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