RADIOLOGY IMAGING ASSOCIATES, LLC – Diagnostic Radiology Physician, NPI 1063400729
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RADIOLOGY IMAGING ASSOCIATES, LLC
1673, Mason Avenue, Daytona Beach, Volusia County, Florida, 32117, United States
SUITE 305
DAYTONA BEACH, FL 321175515
Phone: (386) 274-6143
Fax: (386) 274-6173
Type: Mailing
Mason Avenue, Daytona Beach, Volusia County, Florida, 32118, United States
SUITE 305
DAYTONA BEACH, FL 321175515
Phone: (386) 274-7118
Fax: (386) 274-6173
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: 2026-01-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (100 days ago).
Enrollment records
20
Earliest due date
2026-02-28
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 |
|---|---|---|---|---|
| O20040318000719 | O | Clinic/Group Practice | FL | TBD |
| O20190829003441 | O | Clinic/Group Practice | PR | 2026-02-28 |
| O20190927000652 | O | Clinic/Group Practice | HI | 2026-03-31 |
| O20200413003802 | O | Clinic/Group Practice | AL | 2026-04-30 |
| O20200819000869 | O | Clinic/Group Practice | TX | 2026-05-31 |
| O20220325002206 | O | Clinic/Group Practice | CA | TBD |
| O20230202002547 | O | Clinic/Group Practice | UT | TBD |
| O20230407000147 | O | Clinic/Group Practice | TN | TBD |
| O20230726003699 | O | Clinic/Group Practice | ID | TBD |
| O20240424001406 | O | Clinic/Group Practice | VI | TBD |
| O20240731002052 | O | Clinic/Group Practice | MA | TBD |
| O20250411001158 | O | Clinic/Group Practice | GA | TBD |
| O20250417003131 | O | Clinic/Group Practice | SC | TBD |
| O20250512002797 | O | Clinic/Group Practice | MI | TBD |
| O20250825000568 | O | Clinic/Group Practice | RI | TBD |
| O20260101000251 | O | Clinic/Group Practice | PA | TBD |
| O20260102000526 | O | Clinic/Group Practice | NC | TBD |
| O20260102000915 | O | Clinic/Group Practice | NJ | TBD |
| O20260115000452 | O | Clinic/Group Practice | VA | TBD |
| O20260130000199 | O | Clinic/Group Practice | NY | 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 32117)
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