PENINSULA RADIOLOGICAL ASSOCIATES LIMITED – Diagnostic Radiology Physician, NPI 1114030426
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PENINSULA RADIOLOGICAL ASSOCIATES LIMITED
PO BOX 12087
NEWPORT NEWS, VA 23612
Phone: (757) 867-6101
Fax: (757) 867-6587
Type: Mailing
PO BOX 844724
BOSTON, MA 022844724
Phone: (866) 759-4524
Fax: (757) 512-5025
Type: Mailing
Riverside Regional Medical Center, 500, J Clyde Morris Boulevard, Deer Park, Newport News, Newport News City, Virginia, 23601, United States
NEWPORT NEWS, VA 236011929
Phone: (757) 612-9999
Fax: (757) 512-5025
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: 2025-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (803 days ago).
Enrollment records
23
Earliest due date
2024-03-31
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 |
|---|---|---|---|---|
| O20031219000759 | O | Clinic/Group Practice | NC | TBD |
| O20040428001336 | O | Clinic/Group Practice | VA | 2024-03-31 |
| O20231221000994 | O | Clinic/Group Practice | TX | TBD |
| O20240531003862 | O | Clinic/Group Practice | FL | TBD |
| O20240826003904 | O | Clinic/Group Practice | IL | TBD |
| O20240826004260 | O | Clinic/Group Practice | AZ | TBD |
| O20240827001980 | O | Clinic/Group Practice | DC | TBD |
| O20240827002365 | O | Clinic/Group Practice | CA | TBD |
| O20240827003994 | O | Clinic/Group Practice | HI | TBD |
| O20240827004164 | O | Clinic/Group Practice | WA | TBD |
| O20240828000838 | O | Clinic/Group Practice | MD | TBD |
| O20240828001208 | O | Clinic/Group Practice | NV | TBD |
| O20240829000596 | O | Clinic/Group Practice | PA | TBD |
| O20240829000672 | O | Clinic/Group Practice | MN | TBD |
| O20240903000223 | O | Clinic/Group Practice | NJ | TBD |
| O20240903004336 | O | Clinic/Group Practice | PR | TBD |
| O20240913001850 | O | Clinic/Group Practice | KS | TBD |
| O20240923000473 | O | Clinic/Group Practice | MI | TBD |
| O20241007001175 | O | Clinic/Group Practice | KY | TBD |
| O20241025003398 | O | Clinic/Group Practice | MA | TBD |
| O20250108000709 | O | Clinic/Group Practice | OH | TBD |
| O20250604002745 | O | Clinic/Group Practice | GA | TBD |
| O20250617003649 | O | Clinic/Group Practice | DE | 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 23612)
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