MT BAKER IMAGING LLC – Diagnostic Radiology Physician, NPI 1295725133
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MT BAKER IMAGING LLC
PO BOX 24326
SEATTLE, WA 981240326
Phone: (360) 647-2422
Fax: (360) 255-2263
Type: Mailing
Squalicum Parkway, Cornwall Park, Bellingham, Whatcom County, Washington, 98226, United States
BELLINGHAM, WA 982251854
Phone: (360) 733-0430
Fax: (360) 594-4012
Type: Location
1610 Grover St
SUITE A-4
Lynden, WA 982641539
Phone: (360) 733-0430
Fax: (360) 733-0438
Type: Location
801, West Orchard Drive, Cornwall Park, Bellingham, Whatcom County, Washington, 98226, United States
SUITE 8
BELLINGHAM, WA 982251763
Phone: (360) 733-0430
Fax: (360) 733-0438
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: 2024-01-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| O20050705000191 | O | Clinic/Group Practice | WA | TBD |
| O20240125002409 | O | Clinic/Group Practice | AK | 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 98124)
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