Clermont Radiology-Kings Ridge – Radiology Clinic/Center, NPI 1003328642

Clermont Radiology-Kings Ridge is a healthcare provider. based in Orlando, Florida. specializing in Radiology Clinic/Center. The NPI Number for Clermont Radiology-Kings Ridge is 1003328642

Main info

Organization
Name
Clermont Radiology-Kings Ridge
NPI
1003328642
Phone
(352) 241-6100
Address
PO BOX 593869
Authorized Official
MR. ROBERT S. KOLB PRESIDENT/CEO
Enumeration Date
3 November 2017
Last Update Date
3 November 2017
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness80
Years active:8State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Clermont Radiology-Kings Ridge

  • Pop in a Box, 800, Avenida Presidente Juscelino Kubitscheck de Oliveira, Jardim Panorama, São José do Rio Preto, Região Imediata de São José do Rio Preto, Região Geográfica Intermediária de São José do Rio Preto, São Paulo, Southeast Region, 15092-450, Brazil

    ORLANDO, FL 328593869

    Phone: (352) 241-6100

    Fax: (352) 241-6101

    Type: Mailing

  • 3725 SOUTH HIGHWAY 27

    SUITE 104

    CLERMONT, FL 34711

    Phone: (352) 241-6100

    Fax: (352) 241-6101

    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: 2019-02-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (588 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190221000631OIndependent Diagnostic Testing Facility (Idtf)FL2024-10-31

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
A9552Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries108102$0
A9596Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie7115$0
78815Nuclear medicine study from skull base to mid-thigh with ct scan7065$0
78608Nuclear medicine study of brain with metabolic evaluation4242$0
78803Nuclear medicine study, spect imaging, 1 area or single acquisition, single day imaging3232$0
View full utilization report →

Insurance plans in this area (ZIP 32859)

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Reviews

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Frequently asked questions

What federal number belongs to Clermont Radiology-Kings Ridge?
The federal identifier for Clermont Radiology-Kings Ridge is NPI 1003328642.
Is Clermont Radiology-Kings Ridge's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is Clermont Radiology-Kings Ridge?
The page reflects Radiology Clinic/Center for Clermont Radiology-Kings Ridge. Clinical services aligned with this taxonomy classification.
What location metadata exists for Clermont Radiology-Kings Ridge?
The page summarizes Orlando, Florida for Clermont Radiology-Kings Ridge; expand the address list for detail.
Is Clermont Radiology-Kings Ridge a real provider?
This page reflects official NPPES data for NPI 1003328642. Always confirm identity and privileges with the practice and licensing boards.

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