DR. KIMBERLY BROWN BROCKENBROUGH (M.D.) – Diagnostic Radiology Physician, NPI 1205864204
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,262 DIAGNOSTIC RADIOLOGY in WA
Provider Addresses for DR. KIMBERLY BROWN BROCKENBROUGH (M.D.)
19020 33rd Ave W
Suite 210
Lynnwood, WA 980364746
Phone: (425) 563-1500
Fax: (425) 563-1374
Type: Location
2929 E THOMAS RD
PHOENIX, AZ 850168034
Phone: (602) 470-5000
Fax: (602) 470-5064
Type: Mailing
19020, 33rd Avenue West, Lynnwood, Snohomish County, Washington, 98036, United States
SUITE 210
LYNNWOOD, WA 980364746
Phone: (425) 563-1500
Fax: (425) 563-1374
Type: Mailing
2601 E ROOSEVELT ST
PHOENIX, AZ 850084973
Phone: (602) 344-5011
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2023-11-21 • Largest payer in this snapshot: Cleerly, Inc. ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Cleerly, Inc. | $21 |
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: 2025-05-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20040423000200 | I | Diagnostic Radiology | IL | TBD |
| I20140821001080 | I | Diagnostic Radiology | WA | TBD |
| I20230327001776 | I | Diagnostic Radiology | CO | TBD |
| I20241205002337 | I | Diagnostic Radiology | IN | TBD |
| I20250512002645 | I | Diagnostic Radiology | AZ | 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 |
|---|---|---|---|---|
| 74177 | Ct scan of abdomen and pelvis with contrast | 123 | 122 | $0 |
| 71275 | Ct scan of blood vessels of chest with contrast | 65 | 65 | $0 |
| 71250 | Ct scan of chest without contrast | 62 | 62 | $0 |
| 74176 | Ct scan of abdomen and pelvis without contrast | 48 | 48 | $0 |
| 71260 | Ct scan of chest with contrast | 47 | 47 | $0 |
Insurance plans in this area (ZIP 98036)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| - | AZ | |
| - | AZ | |
| General Surgery, Critical Care (Intensivists) | MI | |
| General Surgery | IL | |
| General Surgery | AZ | |
| - | AZ | |
| Diagnostic Radiology | NC | |
| - | AZ | |
| - | AZ |
Reviews
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