PHOENIX RADIOLOGY, PLLC
NPI 1164493334
Radiology - Vascular & Interventional Radiology in Lewiston, ID
About Phoenix Radiology, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHOENIX RADIOLOGY, PLLC (NPI 1164493334) is a healthcare organization registered as a vascular & interventional radiology in Lewiston, Idaho and active in the NPI registry since January 2006. The organization lists Mark W Peterson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Phoenix Radiology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Phoenix Radiology, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Phoenix Radiology, PLLC's NPI number?
The NPI number for Phoenix Radiology, PLLC is 1164493334. It was assigned to this organization in the NPPES registry on January 27, 2006.
Where is Phoenix Radiology, PLLC located?
Phoenix Radiology, PLLC is located at 415 6th St, Lewiston, ID 83501. The listed phone number is (208) 799-5335.
What is Phoenix Radiology, PLLC's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.
Is Phoenix Radiology, PLLC enrolled in Medicare?
Yes. Phoenix Radiology, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Phoenix Radiology, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Diagnostic Radiology, reassign their Medicare billing to Phoenix Radiology, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Phoenix Radiology, PLLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Phoenix Radiology, Pllc · NPI 1164493334
Vascular & Interventional Radiology organization in Lewiston, Idaho. Organization record, active in the CMS NPPES registry since January 27, 2006.
## Identity
- **NPI:** 1164493334 (Entity type: Organization)
- **Enumerated:** January 27, 2006
- **Primary specialty:** Radiology - Vascular & Interventional Radiology · taxonomy 2085R0204X
- **Organization subpart:** No
- **Authorized official:** Mark Peterson, OWNER
## Practice location
- **Address:** 415 6TH ST, Lewiston, ID 83501-2431
- **Phone:** (208) 799-5335
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians (Diagnostic Radiology) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2025
- **Other identifiers:** Other DC3860; Other 0192979 (WA); Other 000010148406 (ID); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1164493334) · Data from the CMS NPPES public registry.