RADIOLOGY GROUP PC SC – Diagnostic Radiology Physician, NPI 1073573994
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RADIOLOGY GROUP PC SC
1970, East 53rd Street, Davenport, Scott County, Iowa, 52807, United States
DAVENPORT, IA 528072710
Phone: (563) 359-3949
Type: Mailing
Genesis Medical Center, 1227, East Rusholme Street, Davenport, Scott County, Iowa, 52803, United States
DAVENPORT, IA 528032459
Phone: (563) 359-3949
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: 2026-02-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (832 days ago).
Enrollment records
18
Earliest due date
2024-02-29
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 |
|---|---|---|---|---|
| O20040312000682 | O | Clinic/Group Practice | IA | 2024-02-29 |
| O20111128000781 | O | Clinic/Group Practice | IL | 2024-06-30 |
| O20250903002119 | O | Clinic/Group Practice | MI | TBD |
| O20250904001153 | O | Clinic/Group Practice | FL | TBD |
| O20250904003751 | O | Clinic/Group Practice | KS | TBD |
| O20250911003284 | O | Clinic/Group Practice | MN | TBD |
| O20250919003656 | O | Clinic/Group Practice | AL | TBD |
| O20250922000159 | O | Clinic/Group Practice | VA | TBD |
| O20251006003009 | O | Clinic/Group Practice | CA | TBD |
| O20251008000246 | O | Clinic/Group Practice | MA | TBD |
| O20251013003898 | O | Clinic/Group Practice | DE | TBD |
| O20251014004094 | O | Clinic/Group Practice | MD | TBD |
| O20251014004327 | O | Clinic/Group Practice | TX | TBD |
| O20251020001768 | O | Clinic/Group Practice | WI | TBD |
| O20251120002976 | O | Clinic/Group Practice | WA | TBD |
| O20251121003708 | O | Clinic/Group Practice | HI | TBD |
| O20251121003961 | O | Clinic/Group Practice | AZ | TBD |
| O20260204002152 | O | Clinic/Group Practice | DC | 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 52807)
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