AMY L ELLENBOGEN (MD) – Diagnostic Radiology Physician, NPI 1336584101
Diagnostic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,529 DIAGNOSTIC RADIOLOGY in VA
Provider Addresses for AMY L ELLENBOGEN (MD)
1240 Lee St
Charlottesville, VA 229080817
Phone: (434) 243-6888
Fax: (434) 243-6999
Type: Location
1215 Lee St
Charlottesville, VA 229080816
Phone: (434) 297-5055
Fax: (434) 244-9489
Type: Location
PO BOX 9007
CHARLOTTESVILLE, VA 229069007
Phone:
Type: Mailing
1215 LEE ST
CHARLOTTESVILLE, VA 229080816
Phone: (434) 924-9400
Fax: (434) 982-1618
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: 2021-08-06
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 |
|---|---|---|---|---|
| I20210806002395 | I | Diagnostic Radiology | CA | 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 |
|---|---|---|---|---|
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 5,180 | 35 | $0 |
| 72148 | Mri scan of lower spinal canal without contrast | 426 | 423 | $0 |
| 73721 | Mri scan of leg joint without contrast | 208 | 196 | $0 |
| 72141 | Mri scan of upper spinal canal without contrast | 176 | 174 | $0 |
| 73221 | Mri scan of arm joint without contrast | 176 | 166 | $0 |
Insurance plans in this area (ZIP 22908)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | CO | |
| - | PR | |
| Diagnostic Radiology | MD | |
| - | CA | |
| Physician Assistant | CA | |
| Diagnostic Radiology | WI | |
| Diagnostic Radiology | CA |
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