KENNEWICK RADIOLOGY GROUP PC – Diagnostic Radiology Physician, NPI 1679783534
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KENNEWICK RADIOLOGY GROUP PC
Trios Women's and Children's Hospital, 900, South Auburn Street, Kennewick, Benton County, Washington, 99336, United States
KENNEWICK, WA 993365621
Phone: (559) 455-4009
Fax: (509) 586-5178
Type: Location
Podere Pascolo, Pinzale, Prato, Tuscany, 59100, Italy
PASCO, WA 993024030
Phone: (509) 392-5037
Fax: (559) 455-4004
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: 2025-07-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (585 days ago).
Enrollment records
24
Earliest due date
2024-10-31
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 |
|---|---|---|---|---|
| O20070802000143 | O | Clinic/Group Practice | WA | TBD |
| O20090827000849 | O | Clinic/Group Practice | AZ | 2025-12-31 |
| O20190313002001 | O | Clinic/Group Practice | FL | 2024-10-31 |
| O20190314002056 | O | Clinic/Group Practice | OR | TBD |
| O20190314002345 | O | Clinic/Group Practice | HI | 2026-02-28 |
| O20190318001626 | O | Clinic/Group Practice | WY | TBD |
| O20190402002270 | O | Clinic/Group Practice | DC | 2026-04-30 |
| O20190403001182 | O | Clinic/Group Practice | MD | 2026-05-31 |
| O20190422001397 | O | Clinic/Group Practice | VA | 2026-06-30 |
| O20190920000264 | O | Clinic/Group Practice | KS | 2026-07-31 |
| O20200303000913 | O | Clinic/Group Practice | MN | 2026-08-31 |
| O20200812001233 | O | Clinic/Group Practice | OH | TBD |
| O20201014002564 | O | Clinic/Group Practice | MI | 2026-09-30 |
| O20211122000901 | O | Clinic/Group Practice | MA | TBD |
| O20211202002259 | O | Clinic/Group Practice | IL | TBD |
| O20220112000336 | O | Clinic/Group Practice | NY | TBD |
| O20220214000677 | O | Clinic/Group Practice | OK | TBD |
| O20220218002485 | O | Clinic/Group Practice | PR | TBD |
| O20220921002278 | O | Clinic/Group Practice | VT | TBD |
| O20221227000696 | O | Clinic/Group Practice | WI | TBD |
| O20230905003336 | O | Clinic/Group Practice | KY | TBD |
| O20231002002388 | O | Clinic/Group Practice | PA | TBD |
| O20250627003561 | O | Clinic/Group Practice | NE | TBD |
| O20250728002348 | 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 99336)
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