ELMER C SAN PEDRO (MD) – Diagnostic Radiology Physician, NPI 1174532535
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,529 DIAGNOSTIC RADIOLOGY in VA
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Provider Addresses for ELMER C SAN PEDRO (MD)
Sentara Halifax Regional Hospital, 2204, Wilborn Avenue, South Boston, Halifax County, Virginia, 24592, United States
SOUTH BOSTON, VA 245921645
Phone: (434) 517-3403
Fax: (434) 517-3686
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: 2018-12-04
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 |
|---|---|---|---|---|
| I20080211000855 | I | Diagnostic Radiology | VA | TBD |
| I20181204003080 | I | Diagnostic Radiology | NC | 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 |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 1,318 | 807 | $0 |
| 77067 | Screening mammography | 575 | 575 | $0 |
| 77063 | Screening 3d breast mammography | 575 | 575 | $0 |
| 71046 | X-ray of chest, 2 views | 385 | 336 | $0 |
| 70450 | Ct scan head or brain without contrast | 216 | 201 | $0 |
Insurance plans in this area (ZIP 24592)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | VA | 71250 | CT scan chest | 176 | 166 |
| DIAGNOSTIC RADIOLOGY | VA | 74177 | CT scan of abdomen and pelvis with contrast | 181 | 168 |
| DIAGNOSTIC RADIOLOGY | VA | 93926 | Ultrasound study of arteries and arterial grafts of one leg or limited | 12 | 12 |
| DIAGNOSTIC RADIOLOGY | VA | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 117 | 111 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VA | |
| General Surgery | VA | |
| Sports Medicine, Orthopedic Surgery | VA | |
| Orthopedic Surgery | VA | |
| Nurse Practitioner | VA | |
| Diagnostic Radiology | VA | |
| General Surgery | VA | |
| - | VA | |
| - | VA | |
| Orthopedic Surgery | VA |
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