RADIOLOGY PROFESSIONALS, PA – Diagnostic Radiology Physician, NPI 1912984089
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RADIOLOGY PROFESSIONALS, PA
Mercy Hospital, 144, State Street, Old Port, Portland, Cumberland County, Maine, 04102, United States
PORTLAND, ME 041013776
Phone: (207) 879-3000
Type: Location
Lewiston Post Office, 49, Ash Street, Lewiston, Androscoggin County, Maine, 04240, United States
LEWISTON, ME 042411849
Phone: (207) 784-2554
Fax: (207) 777-5363
Type: Mailing
PO BOX 986520 DEPARTMENT 250
BOSTON, MA 022986520
Phone: (207) 784-2554
Fax: (207) 777-1439
Type: Mailing
175 FORE RIVER PKWY
PORTLAND, ME 041022779
Phone: (207) 879-3000
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: 2025-02-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| O20060215000764 | O | Clinic/Group Practice | ME | TBD |
| O20241216000302 | O | Clinic/Group Practice | MA | TBD |
| O20250219002715 | O | Clinic/Group Practice | NH | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04101)
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