PROVIDENCE DIAGNOSTIC IMAGING, INC. – Diagnostic Radiology Physician, NPI 1609978170
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PROVIDENCE DIAGNOSTIC IMAGING, INC.
Mercy Medical Center, 271, Carew Street, North End, Springfield, Hampden County, Massachusetts, 01104, United States
SPRINGFIELD, MA 011042377
Phone: (413) 748-9200
Mailing address matches the actual address.
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: 2024-01-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (618 days ago).
Enrollment records
8
Earliest due date
2024-09-30
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 |
|---|---|---|---|---|
| O20040508000173 | O | Clinic/Group Practice | MA | TBD |
| O20120821000823 | O | Clinic/Group Practice | CT | TBD |
| O20190218002969 | O | Clinic/Group Practice | CA | 2024-09-30 |
| O20190403002251 | O | Clinic/Group Practice | FL | 2026-02-28 |
| O20210831000229 | O | Clinic/Group Practice | TX | 2026-09-30 |
| O20231006000933 | O | Clinic/Group Practice | MT | TBD |
| O20231025002316 | O | Clinic/Group Practice | NC | TBD |
| O20240123000089 | O | Clinic/Group Practice | WA | 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 01104)
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