Unknown Individual – Diagnostic Radiology Physician, NPI 1639140882
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,576 DIAGNOSTIC RADIOLOGY in PA
Provider Addresses for Unknown Individual
304 CHAUCER CT N
SEWICKLEY, PA 151438728
Phone: (412) 741-5717
Fax: (412) 741-6973
Type: Mailing
11995 SINGLETREE LN STE 500
EDEN PRAIRIE, MN 553445349
Phone: (952) 595-1301
Type: Location
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: 2016-10-03
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 |
|---|---|---|---|---|
| I20050210000260 | I | Diagnostic Radiology | PA | TBD |
| I20161003000782 | I | Diagnostic Radiology | TX | 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 |
|---|---|---|---|---|
| 71046 | X-ray of chest, 2 views | 85 | 79 | $0 |
| 93971 | Ultrasound study of one arm or leg veins with compression and maneuvers | 59 | 50 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 44 | 35 | $0 |
| 76536 | Ultrasound scan of head and neck soft tissue | 29 | 29 | $0 |
| 73502 | X-ray of hip, 2-3 views | 28 | 28 | $0 |
Insurance plans in this area (ZIP 15143)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | PA | |
| P O D I A T R Y | PA | |
| General Surgery | PA |
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