RADIOLOGY CHARTERED – Diagnostic Radiology Physician, NPI 1760416895
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for RADIOLOGY CHARTERED
325 Bishop Woods Rd
Marquette, MI 498558606
Phone: (920) 499-1428
Fax: (920) 499-7080
Type: Location
1789, Shawano Avenue, Green Bay, Brown County, Wisconsin, 54303, United States
GREEN BAY, WI 543033243
Phone: (920) 499-1428
Fax: (920) 499-7080
Type: Mailing
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: 2025-11-19
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
16
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 |
|---|---|---|---|---|
| O20050915000492 | O | Clinic/Group Practice | WI | 2024-09-30 |
| O20230629003693 | O | Clinic/Group Practice | MI | TBD |
| O20240118001887 | O | Clinic/Group Practice | RI | TBD |
| O20240118001934 | O | Clinic/Group Practice | CA | TBD |
| O20240220003695 | O | Clinic/Group Practice | GA | TBD |
| O20240321000486 | O | Clinic/Group Practice | MA | TBD |
| O20240620000013 | O | Clinic/Group Practice | IL | TBD |
| O20250827004064 | O | Clinic/Group Practice | ME | TBD |
| O20250902000719 | O | Clinic/Group Practice | MN | TBD |
| O20250913000546 | O | Clinic/Group Practice | TX | TBD |
| O20250926000746 | O | Clinic/Group Practice | FL | TBD |
| O20251003003756 | O | Clinic/Group Practice | WA | TBD |
| O20251014001546 | O | Clinic/Group Practice | AZ | TBD |
| O20251021000313 | O | Clinic/Group Practice | KY | TBD |
| O20251029000695 | O | Clinic/Group Practice | MO | TBD |
| O20251119002226 | O | Clinic/Group Practice | IA | 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 49855)
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