Organization Active NPI

Kennewick Radiology Group PC

  • Diagnostic Radiology Physician
  • Kennewick, WA
National Provider Identifier
1679783534
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
KENNEWICK RADIOLOGY GROUP PC
Practice address
3810 Plaza Way
Kennewick, WA 99338-2722
Phone
(509) 221-7000
Fax
(509) 221-7748
NPI assigned
May 22, 2007
Last updated
Jul 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandip Arvind PatidarNPI 1063463784
Title
Owner
Phone
(858) 692-9729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

3810 Plaza Way
Kennewick, WA 99338-2722

Mailing address

PO Box 9186
Longview, TX 75608-9186
Phone (903) 663-4800

Other identifiers 2

IdentifierTypeStateIssuer
7138209MedicaidWA
006814MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AZ, FL, CA, OR, HI, WY, TX, DC, MD, VA, KS, MN, OH, MI, MA, IL, NY, OK, PR, VT, WI, KY, PA, NE, DE26 enrollments

Enrollment records 26

Enrollment IDStateProvider typePAC IDDetails
O20070802000143 WA Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 9 practitioners
Practice locations: Bellevue, WA; Camas, WA; Kenmore, WA; Kennewick, WA; Pasco, WA
O20090827000849 AZ Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 2 practitioners
Practice locations: Scottsdale, AZ; Chandler, AZ
O20190313002001 FL Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 6 practitioners
Practice locations: Lantana, FL; Miami Beach, FL; Orlando, FL; Oviedo, FL; Wesley Chapel, FL; Windermere, FL
O20190314000693 CA Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 8 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Truckee, CA; Irvine, CA; San Luis Obispo, CA; San Diego, CA; Pasadena, CA; Newport Coast, CA; Roseville, CA
O20190314002056 OR Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Newberg, OR
O20190314002345 HI Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 2 practitioners
Practice locations: Honolulu, HI; Kaneohe, HI
O20190318001626 WY Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Wilson, WY
O20190319000921 TX Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Plano, TX; Spring, TX; San Antonio, TX; Lumberton, TX; Houston, TX; Dallas, TX; Austin, TX
O20190402002270 DC Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 4 practitioners
Practice locations: Potomoc, MD; Bethesda, MD; Arlington, VA
O20190403001182 MD Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Pikesville, MD
O20190422001397 VA Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 4 practitioners
Practice locations: Ashburn, VA; Williamsburg, VA; Leesburg, VA; Danville, VA; Hillsboro, VA
O20190920000264 KS Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrence, KS
O20200303000913 MN Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 2 practitioners
Practice locations: Edina, MN; Plymouth, MN
O20200812001233 OH Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Avon, OH
O20201014002564 MI Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 2 practitioners
Practice locations: Ann Arbor, MI; Detroit, MI
O20211122000901 MA Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 2 practitioners
Practice locations: Worcester, MA
O20211202002259 IL Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Forest, IL; Oak Brook, IL
O20220112000336 NY Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Manhasset, NY; Cornwall, NY
O20220214000677 OK Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 4 practitioners
Practice locations: Nichols Hills, OK; Oklahoma City, OK; Tulsa, OK
O20220218002485 PR Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR
O20220921002278 VT Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: East Dorset, VT
O20221227000696 WI Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Eau Claire, WI
O20230905003336 KY Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Crestwood, KY
O20231002002388 PA Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Girard, PA
O20250627003561 NE Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE
O20250728002348 DE Part B Supplier - Clinic/Group Practice 9335230549 Receives reassigned benefits from 1 practitioner
Practice locations: Magnolia, DE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

8530 W Sunset Rd
Ste 120
Las Vegas, NV 89113
Phone (310) 993-9118

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 60

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1679783534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9186",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756089186",
            "telephone_number": "903-663-4800",
            "fax_number": "903-663-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 PLAZA WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382722",
            "telephone_number": "509-221-7000",
            "fax_number": "509-221-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEWICK RADIOLOGY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "PATIDAR",
        "authorized_official_first_name": "SANDIP",
        "authorized_official_middle_name": "ARVIND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-692-9729"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7138209",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006814",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.