BRIDGEWAY DIAGNOSTIC RADIOLOGY – Diagnostic Radiology Physician, NPI 1306248729
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BRIDGEWAY DIAGNOSTIC RADIOLOGY
PO BOX 242848
MONTGOMERY, AL 361242848
Phone: (334) 386-9357
Fax: (334) 532-0137
Type: Mailing
5007 SUMMERVILLE ROAD
PHENIX CITY, AL 368671559
Phone: (334) 408-2854
Fax: (334) 384-9274
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: 2023-09-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (714 days ago).
Enrollment records
8
Earliest due date
2024-06-30
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 |
|---|---|---|---|---|
| O20150108001370 | O | Clinic/Group Practice | AL | TBD |
| O20190604001681 | O | Clinic/Group Practice | GA | 2024-06-30 |
| O20230720003099 | O | Clinic/Group Practice | CA | TBD |
| O20230731001098 | O | Clinic/Group Practice | SC | TBD |
| O20230802000030 | O | Clinic/Group Practice | FL | TBD |
| O20230824003549 | O | Clinic/Group Practice | IL | TBD |
| O20230831000132 | O | Clinic/Group Practice | PA | TBD |
| O20230921000880 | O | Clinic/Group Practice | TX | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 36124)
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