Evergreen Radia – Diagnostic Radiology Physician, NPI 1922095694
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Evergreen Radia
33rd Avenue West, Lynnwood, Snohomish County, Washington, 98037, United States
LYNNWOOD, WA 980364748
Phone: (425) 563-1500
Fax: (425) 563-1501
Type: Mailing
11521, Northeast 128th Street, Kirkland, King County, Washington, 98034, United States
SUITE 200
KIRKLAND, WA 980344317
Phone: (425) 952-6100
Fax: (425) 952-6150
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: 2025-11-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (100 days ago).
Enrollment records
29
Earliest due date
2026-02-28
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 |
|---|---|---|---|---|
| O20031125000896 | O | Clinic/Group Practice | WA | TBD |
| O20200501001503 | O | Clinic/Group Practice | CA | 2026-02-28 |
| O20220110000824 | O | Clinic/Group Practice | HI | TBD |
| O20220627001586 | O | Clinic/Group Practice | UT | TBD |
| O20220801002607 | O | Clinic/Group Practice | VA | TBD |
| O20220811000481 | O | Clinic/Group Practice | AZ | TBD |
| O20220811002363 | O | Clinic/Group Practice | OR | TBD |
| O20220909000012 | O | Clinic/Group Practice | FL | TBD |
| O20221103002799 | O | Clinic/Group Practice | MA | TBD |
| O20221202000482 | O | Clinic/Group Practice | TX | TBD |
| O20231020002232 | O | Clinic/Group Practice | GA | TBD |
| O20231122000281 | O | Clinic/Group Practice | NE | TBD |
| O20231130000851 | O | Clinic/Group Practice | MI | TBD |
| O20240410000950 | O | Clinic/Group Practice | MO | TBD |
| O20240418000021 | O | Clinic/Group Practice | DC | TBD |
| O20240423000363 | O | Clinic/Group Practice | AL | TBD |
| O20240423001259 | O | Clinic/Group Practice | NC | TBD |
| O20240614003382 | O | Clinic/Group Practice | NV | TBD |
| O20240624000191 | O | Clinic/Group Practice | PA | TBD |
| O20240708003362 | O | Clinic/Group Practice | IA | TBD |
| O20240711001245 | O | Clinic/Group Practice | ID | TBD |
| O20240822002990 | O | Clinic/Group Practice | SC | TBD |
| O20241113002414 | O | Clinic/Group Practice | CO | TBD |
| O20250424000132 | O | Clinic/Group Practice | CT | TBD |
| O20250523001155 | O | Clinic/Group Practice | MD | TBD |
| O20250627000068 | O | Clinic/Group Practice | OK | TBD |
| O20250910000164 | O | Clinic/Group Practice | OH | TBD |
| O20250919003581 | O | Clinic/Group Practice | TN | TBD |
| O20251124001004 | O | Clinic/Group Practice | IL | 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 98036)
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