Diagnostic Radiologists PC

NPI 1053368563ActiveOrganization· Radiology, Diagnostic Radiology· Portland, OR

Radiology, Diagnostic Radiology in Portland, Oregon, registered in NPPES in May 2006. The authorized official on file is Jed Russell Peterson, MD, President. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.

Overview

NPI	1053368563
Status	Active
Entity type	Organization
NPI issued	May 28, 2006
Last updated in NPPES	Oct 29, 2024
Certified by provider	Oct 29, 2024

Specialties and licenses

Taxonomy	Code	License	State
Radiology, Diagnostic Radiology Primary	2085R0202X	—	—

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Oct 9, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026	No match	—
New York OMIG · Nov 10, 2026	No match	—
Ohio Medicaid · Nov 10, 2026	No match	—
Pennsylvania Medicheck · Nov 10, 2026	No match	—
Washington HCA · Nov 10, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (HI); Part B Supplier - Clinic/Group Practice (KS); Part B Supplier - Clinic/Group Practice (KY); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (MN); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (NV); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (OH); Part B Supplier - Clinic/Group Practice (OR); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (PR); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (VA); Part B Supplier - Clinic/Group Practice (VT); Part B Supplier - Clinic/Group Practice (WA); Part B Supplier - Clinic/Group Practice (WY)

Enrollment (PECOS)

Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (DC); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (HI); Part B Supplier - Clinic/Group Practice (KS); Part B Supplier - Clinic/Group Practice (KY); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (MN); Part B Supplier - Clinic/Group Practice (NJ); Part B Supplier - Clinic/Group Practice (NV); Part B Supplier - Clinic/Group Practice (NY); Part B Supplier - Clinic/Group Practice (OH); Part B Supplier - Clinic/Group Practice (OR); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (PR); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (VA); Part B Supplier - Clinic/Group Practice (VT); Part B Supplier - Clinic/Group Practice (WA); Part B Supplier - Clinic/Group Practice (WY)

Medicare sources and data years

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