DR. THEODORE JENNERMANN (MD) – Diagnostic Radiology Physician, NPI 1073891735
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
532 DIAGNOSTIC RADIOLOGY in OR
Provider Addresses for DR. THEODORE JENNERMANN (MD)
1460 NE MEDICAL CENTER DR
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.
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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: 2020-04-16
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 |
|---|---|---|---|---|
| I20200416003455 | 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 |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 19,999 | 206 | $0 |
| A9585 | Injection, gadobutrol, 0.1 ml | 2,880 | 21 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 394 | 273 | $0 |
| 71046 | X-ray of chest, 2 views | 364 | 343 | $0 |
| 71260 | Ct scan of chest with contrast | 339 | 212 | $0 |
Insurance plans in this area (ZIP 97701)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| General Surgery, Thoracic Surgery | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| Nurse Practitioner | OR | |
| - | OR |
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