ELLEN A FAULK (MD) – Diagnostic Radiology Physician, NPI 1003378654
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,529 DIAGNOSTIC RADIOLOGY in VA
Provider Addresses for ELLEN A FAULK (MD)
1215 Lee St Dept Of
Charlottesville, VA 229080816
Phone: (434) 924-0000
Type: Location
Fairfield Avenue, Greenbrook, Shreveport, Caddo Parish, Louisiana, 71106, United States
SHREVEPORT, LA 711044152
Phone: (985) 259-2276
Type: Mailing
1215 LEE ST DEPT OF
CHARLOTTESVILLE, VA 229080816
Phone: (434) 924-0000
Type: Location
PO BOX 749112
ATLANTA, GA 303749112
Phone: (434) 295-1000
Type: Mailing
1215 LEE ST
CHARLOTTESVILLE, VA 229080816
Phone: (434) 924-9400
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: 2025-07-25
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 |
|---|---|---|---|---|
| I20240613003313 | I | Diagnostic Radiology | VA | TBD |
| I20250725002239 | I | Diagnostic Radiology | LA | 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 22908)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | TX | |
| Diagnostic Radiology | GA | |
| Diagnostic Radiology | AL | |
| Physician Assistant | LA | |
| Physician Assistant | LA | |
| Diagnostic Radiology, Interventional Radiology | LA | |
| Diagnostic Radiology | LA | |
| - | LA | |
| Diagnostic Radiology | LA | |
| Diagnostic Radiology, Interventional Radiology | LA |
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