TELLICA IMAGING, LLC
NPI 1760197198
Clinic/Center - Radiology in Boise, ID
About Tellica Imaging, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TELLICA IMAGING, LLC (NPI 1760197198) is a healthcare organization registered as a radiology in Boise, Idaho and active in the NPI registry since January 2023. The organization lists Mark L Vawdrey, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tellica Imaging, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
120Medicare enrollment records show 120 clinicians reassign Medicare billing to Tellica Imaging, LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 120Source: 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 Tellica Imaging, LLC's NPI number?
The NPI number for Tellica Imaging, LLC is 1760197198. It was assigned to this organization in the NPPES registry on January 19, 2023.
Where is Tellica Imaging, LLC located?
Tellica Imaging, LLC is located at 8505 W Overland Rd, Boise, ID 83709. The listed phone number is (208) 417-5100.
What is Tellica Imaging, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.
Is Tellica Imaging, LLC enrolled in Medicare?
Yes. Tellica Imaging, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tellica Imaging, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 120 clinicians in 4 Medicare specialties reassign their Medicare billing to Tellica Imaging, LLC. 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. The largest specialties are Diagnostic Radiology (108), Interventional Radiology (8) and Nuclear Medicine (2). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Tellica Imaging, LLC accept?
Health plans from PacificSource Health Plans, Providence Health Plan and Select Health list Tellica Imaging, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tellica Imaging, LLC was last updated on November 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Tellica Imaging, Llc · NPI 1760197198
Radiology organization in Boise, Idaho. Organization record, active in the CMS NPPES registry since January 19, 2023.
## Identity
- **NPI:** 1760197198 (Entity type: Organization)
- **Enumerated:** January 19, 2023
- **Primary specialty:** Clinic/Center - Radiology · taxonomy 261QR0200X
- **Organization subpart:** Yes (part of Intermountain Healthcare)
- **Authorized official:** Mark Vawdrey, CFO
## Practice location
- **Address:** 8505 W OVERLAND RD, Boise, ID 83709-1644
- **Phone:** (208) 417-5100 · **Fax:** (208) 417-5105
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 120 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (108), Interventional Radiology (8), Nuclear Medicine (2); 2 practice within 10 miles; [full list](https://npiprofile.com/npi/1760197198/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 20, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1760197198) · Data from the CMS NPPES public registry.