DR. RICHARD MONROE PENNEY M.D.
NPI 1992949325
Radiology - Vascular & Interventional Radiology in Fargo, ND
Quality Rating: 82.99 out of 100 score
NPI Status: Active since April 29, 2009
Contact Information
5225 23RD AVE S
FARGO, ND
ZIP 58104
Phone: (701) 364-8000
- Individual
- Male
- Years of Experience 23
- Radiology
- Vascular & Interventional Radiology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About RICHARD PENNEY
This page provides the complete NPI Profile along with additional information for Richard Penney, a provider established in Fargo, North Dakota with a medical specialization in Radiology, focusing in vascular & interventional radiology and more than 23 years of experience. He graduated from Loma Linda University School Of Medicine in 2003. The healthcare provider is registered in the NPI registry with number 1992949325 assigned on April 2009. The practitioner's primary taxonomy code is 2085R0204X with license number 13775 (ND). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1992949325
- Provider Name
- DR. RICHARD MONROE PENNEY M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5225 23RD AVE S FARGO, ND 58104
- Location Phone
- (701) 364-8000
- Mailing Address
- PO BOX 5074 SIOUX FALLS, SD 57117
- Mailing Phone
- (701) 364-8000
- Medical School Name
- LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2003
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-29-2009
- Last Update Date
- 07-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Vascular & Interventional Radiology
- Taxonomy Code
- 2085R0204X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 13775
- License State
- ND
- Taxonomy Description
- A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
- BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
- BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
- BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
- BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
- BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
- BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
- BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
- DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
- DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
- DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
- DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $10,600 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,500 - HMO
- Sanford Individual TRUE $7,200 HSA Qualified - HMO
- Sanford Individual TRUE Standardized $2,000 - HMO
- Sanford Individual TRUE Standardized $6,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Richard Penney is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Richard Penney is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 8022149806
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20150723006572
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration of fluid from chest cavity using imaging guidance
Balloon dilation of artery of leg
Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin
Drainage of fluid from abdominal cavity using imaging guidance
Fluoroscopic guidance for insertion or removal of central vein access device
Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance
Injection of contrast through abdominal cavity tube for x-ray study
Insertion of central venous tube with port (5 years or older)
Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist
Insertion of tunneled central venous tube for infusion (5 years or older)
Leg revascularization (restoring blood flow)
Needle biopsy of liver through skin
Removal of central venous tube with port or pump
Removal of tunneled central venous tube
Replacement of kidney drainage tube using imaging guidance with review by radiologist
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast
Replacement of tunneled central venous tube
Review by radiologist of abdominal aorta image
Review by radiologist of abscess or sinus cavity study
Review by radiologist of arm or leg artery image
Review by radiologist of ct guidance for needle placement
Review by radiologist of image for replacement of stomach or large bowel tube
Simple change of bladder tube
Ultrasonic guidance for blood vessel access
Ultrasonic guidance for needle placement
Ultrasound of both sides of head and neck blood flow
Ultrasound of leg arteries at rest and after exercise
Ultrasound of one leg arteries or artery grafts
Ultrasound study of arm and leg arteries
Ultrasound study of arm or leg veins with compression and maneuvers
Ultrasound study of one arm or leg veins with compression and maneuvers
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
Varicose vein removal
This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.
This service was performed 120 times for 84 patientsBalloon dilation of the leg artery is a procedure to improve blood flow. A tiny balloon is inserted into a narrowed artery, then inflated to widen the artery. This helps increase blood circulation to the leg. It's usually done under local anesthesia.
This service was performed 15 times for 12 patientsA core needle biopsy of the lung or mediastinum is a procedure where a small sample of tissue is collected using a needle inserted through the skin. This helps in diagnosing lung conditions or diseases in the chest's central cavity. It's a safe and minimally invasive process.
This service was performed 15 times for 15 patientsThis procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.
This service was performed 100 times for 38 patientsFluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.
This service was performed 41 times for 40 patientsThis procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.
This service was performed 12 times for 12 patientsThis procedure involves injecting a contrast substance through a tube in your abdominal cavity. This helps to highlight certain areas in your body for an X-ray study. It's a crucial step for accurate diagnosis and treatment planning.
This service was performed 20 times for 15 patientsA central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.
This service was performed 16 times for 16 patientsThis procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.
This service was performed 32 times for 30 patientsThe insertion of a tunneled central venous tube is a procedure where a thin, flexible tube is placed into a large vein, usually in the neck or chest. This tube allows healthcare providers to give medications, fluids, or nutrients directly into your bloodstream over a longer period.
This service was performed 28 times for 28 patientsLeg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.
This service was performed for 18 patientsA needle biopsy of the liver through skin is a procedure where a small tissue sample from your liver is collected using a thin needle. This is done to diagnose liver diseases or conditions. It involves inserting the needle through your skin and into your liver.
This service was performed 20 times for 19 patientsThe removal of a central venous tube with port or pump is a procedure that eliminates a device implanted under your skin. This device helped deliver medication or nutrients directly into a large vein near your heart. Its removal involves a minor surgical procedure performed under local anesthesia.
This service was performed 17 times for 17 patientsA tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.
This service was performed 14 times for 14 patientsThis procedure involves replacing an existing kidney drainage tube. Using imaging technology, a radiologist precisely guides the process to ensure accuracy. This helps drain excess fluid from kidneys, improving their function and your comfort.
This service was performed 46 times for 21 patientsThis procedure involves replacing a tube in your stomach or large bowel. It's guided by a special type of X-ray called fluoroscopy, which helps ensure accurate placement. Contrast material is used to enhance the visibility of your internal structures.
This service was performed 25 times for 21 patientsA tunneled central venous tube replacement is a procedure where an existing tube, used to deliver medication or nutrition directly to a large vein, is replaced. This is done under local anesthesia and involves inserting a new tube through a small incision.
This service was performed 11 times for 11 patientsThis is a procedure where a radiologist, a doctor specialized in medical imaging, examines an image of your abdominal aorta. The abdominal aorta is the large blood vessel that carries blood to your lower body. The radiologist checks for any abnormalities to ensure your overall vascular health.
This service was performed 17 times for 15 patientsThis procedure involves a specialist, known as a radiologist, examining images of your abscess or sinus cavity. These images help identify any problems or changes in your condition. The radiologist's review is crucial in determining the best course of treatment.
This service was performed 20 times for 15 patientsThis procedure involves a radiologist examining images of your arm or leg arteries. These images are obtained through a non-invasive method, like an ultrasound or CT scan. The radiologist reviews these images to identify any abnormalities, such as blockages or narrowing, which can affect blood flow.
This service was performed 19 times for 17 patientsThis process involves a radiologist examining CT scan images to accurately guide a needle's placement within the body. This technique is often used for biopsies or treatments, ensuring precision and safety.
This service was performed 18 times for 18 patientsThis procedure involves a radiologist examining images to assess the placement of a tube in your stomach or large bowel. The tube helps with digestion or removal of waste. The radiologist's review ensures the tube is correctly positioned for your safety and comfort.
This service was performed 44 times for 26 patientsA simple change of bladder tube involves replacing your current urinary drainage tube with a new one. This is done to maintain hygiene and prevent infections. It's a straightforward process, usually causing minimal discomfort, and helps ensure your body can properly dispose of waste fluids.
This service was performed 24 times for 18 patientsUltrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.
This service was performed 48 times for 47 patientsUltrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
This service was performed 43 times for 43 patientsAn ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
This service was performed 24 times for 24 patientsAn ultrasound of leg arteries at rest and after exercise involves using sound waves to create images of the blood vessels in your legs. This helps to detect blockages or narrowing. You'll rest, then perform light exercise, and images are taken before and after to compare blood flow.
This service was performed 13 times for 13 patientsAn ultrasound of leg arteries or artery grafts is a non-invasive test using sound waves to create images of your blood vessels. This helps doctors assess blood flow, identify blockages, and monitor the health of grafts.
This service was performed 11 times for 11 patientsAn ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
This service was performed 28 times for 28 patientsAn ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.
This service was performed 36 times for 35 patientsThis is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.
This service was performed 27 times for 27 patientsThis procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
This service was performed 146 times for 129 patientsVaricose vein removal is a procedure to eliminate enlarged and twisted veins, commonly found in legs. It's performed when these veins cause discomfort or skin problems. The procedure may involve laser treatment, sclerotherapy (injecting a solution to close the veins), or surgery to remove the veins. It's generally safe and helps to alleviate symptoms.
This service was performed for 1-10 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.42 for a new patient copayment and $17.37 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 58104 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.71
- Minimum New Patient Price $55.75
- Maximum New Patient Price $168.12
- Average New Patient Copayment $21.42
- Minimum New Patient Copayment $13.93
- Maximum New Patient Copayment $42.03
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.48
- Minimum Established Patient Price $18.11
- Maximum Established Patient Price $137.65
- Average Established Patient Copayment $17.37
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.41
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 82.99, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 82.99 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 87.06
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 99
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 57.08
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 57.08
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Richard Penney is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| SANFORD BEMIDJI MEDICAL CENTER | 1300 ANNE ST NW BEMIDJI, MN 56601 | (218) 751-5430 | Acute Care Hospitals | |
| SANFORD MEDICAL CENTER FARGO | 801 BROADWAY NORTH FARGO, ND 58122 | (701) 234-2000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1992949325, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 75 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FARGO, ND 58104
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992949325, enumerated as an "individual" on April 29, 2009.
The provider is located at 5225 23RD AVE S FARGO, ND 58104 and the phone number is (701) 364-8000.
Radiology with taxonomy code 2085R0204X and a focus in Vascular & Interventional Radiology.
The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota and Sanford. Please consult your insurance carrier or call the provider to verify.
Richard Penney is affiliated with: SANFORD BEMIDJI MEDICAL CENTER and SANFORD MEDICAL CENTER FARGO.