Phoenix Radiology, PLLC
NPI 1164493334ActiveOrganization· Radiology, Vascular & Interventional Radiology· Lewiston, ID
Radiology, Vascular & Interventional Radiology in Lewiston, Idaho, registered in NPPES in January 2006. The authorized official on file is Mark W. Peterson, M.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164493334 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 27, 2006 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Vascular & Interventional Radiology Primary | 2085R0204X | — | — |
| Radiology, Diagnostic Radiology | 2085R0202X | — | — |
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 (ID) |
|---|
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