Intraoperative Monitoring Company – Clinical Neurophysiology Physician, NPI 1972551893
Clinical Neurophysiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Intraoperative Monitoring Company
1141 N LOOP 1604 E STE 105-484
SAN ANTONIO, TX 782321339
Phone: (484) 351-8459
Fax: (484) 351-8810
Type: Mailing
13401, Railway Drive, Oklahoma City, Oklahoma County, Oklahoma, 73114, United States
OKLAHOMA CITY, OK 731142272
Phone: (405) 841-7826
Type: Location
280, Front Street, West Conshohocken, Montgomery County, Pennsylvania, 19428, United States
CONSHOHOCKEN, PA 194282891
Phone: (484) 351-8417
Fax: (484) 351-8810
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: 2025-07-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-07-31 (1044 days ago).
Enrollment records
10
Earliest due date
2023-07-31
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 |
|---|---|---|---|---|
| O20111019000907 | O | Clinic/Group Practice | OK | TBD |
| O20120626000190 | O | Clinic/Group Practice | CA | TBD |
| O20130926000794 | O | Clinic/Group Practice | TX | TBD |
| O20170714000700 | O | Clinic/Group Practice | NJ | 2023-07-31 |
| O20230725003672 | O | Clinic/Group Practice | PA | TBD |
| O20240807003976 | O | Clinic/Group Practice | FL | TBD |
| O20241008004484 | O | Clinic/Group Practice | WA | TBD |
| O20250214002765 | O | Clinic/Group Practice | OH | TBD |
| O20250702002479 | O | Clinic/Group Practice | NY | TBD |
| O20250710001263 | 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 78232)
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