NPIMap

Individual provider Active NPI

Richard Monroe Penney, M.D.

  • Vascular & Interventional Radiology Physician
  • Fargo, ND
National Provider Identifier
1992949325
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
13775 Issued in ND
Practice address
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone
(701) 364-8000
NPI assigned
Apr 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 13775 ND Primary

Addresses

Primary practice location

5225 23Rd Ave S
Fargo, ND 58104-7927

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (701) 364-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141206000395 CA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8022149806 Reassigns benefits to 2 organizations
I20260212002155 AL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8022149806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Joaquin Community HospitalGroup PAC ID 1557390580, 72 clinicians

Practice addresses (Care Compare)

2451 University Hospital Dr
Mobile, AL 36617-2300
Phone (251) 471-7000

2615 Chester Ave
Bakersfield, CA 93301-2014

75 S University Blvd
Unit 6000
Mobile, AL 36608-3274
Phone (251) 660-5555

9602 Stockdale Hwy
Bakersfield, CA 93311-3618
Phone (661) 395-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
89015CAMDInstitutional Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC CurrentSince Jan 20, 2026 Accepting new patients
USA Health Physician Billing Services LLC Family Medicine CurrentSince Jan 20, 2026 Accepting new patients
Glendora Radiological Assoc Inc CurrentSince Jul 24, 2014 Accepting new patients
Teton Radiology Madison LLC PastSince Jul 1, 2009 Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Vascular & Interventional Radiology PastSince Feb 24, 2022 Accepting new patients

Locations

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

414 E San Bernardino Rd
Covina, CA 91723
Phone (626) 367-3206

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1992949325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 23RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047927",
            "telephone_number": "701-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEY",
        "first_name": "RICHARD",
        "middle_name": "MONROE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ND",
            "license": "13775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.