Unknown Individual – Vascular & Interventional Radiology Physician, NPI 1275594087
Vascular & Interventional Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
11475 OLDE CABIN RD STE 200
SAINT LOUIS, MO 631417129
Phone: (314) 991-8200
Type: Mailing
Mercy Hospital Joplin, 100, Mercy Way, Joplin, Newton County, Missouri, 64804, United States
JOPLIN, MO 648044524
Phone: (175) 564-7624
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $62.
Total Amount is formed as General ($62) + Research ($0) + Ownership ($0) = $62.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($62).
Total Amount
$62
General + Research + Ownership
Payments
4
Total payment records
General Amount
$62
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teva Pharmaceuticals USA, Inc. | $62 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 516 | 381 | $0 |
| 71046 | X-ray of chest, 2 views | 175 | 170 | $0 |
| 74018 | X-ray of abdomen, 1 view | 113 | 97 | $0 |
| 73562 | X-ray of knee, 3 views | 60 | 58 | $0 |
| 72100 | X-ray of lower and sacral spine, 2-3 views | 52 | 51 | $0 |
Insurance plans in this area (ZIP 63141)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | MO | 71250 | CT scan chest | 11 | 11 |
| DIAGNOSTIC RADIOLOGY | MO | 73562 | X-ray of knee, 3 views | 25 | 24 |
| DIAGNOSTIC RADIOLOGY | MO | 73630 | X-ray of foot, minimum of 3 views | 25 | 21 |
| DIAGNOSTIC RADIOLOGY | MO | 74177 | CT scan of abdomen and pelvis with contrast | 13 | 13 |
| DIAGNOSTIC RADIOLOGY | MO | 78452 | Nuclear medicine study of vessels of heart using drugs or exercise multiple studies | 185 | 182 |
| DIAGNOSTIC RADIOLOGY | MO | 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 87 | 86 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease, Internal Medicine | MO | |
| Internal Medicine, Pulmonary Disease, Pulmonary Disease, Critical Care (Intensivists) | IN | |
| Physician Assistant | IL | |
| Nurse Practitioner | MO | |
| Family Practice | MO | |
| Vascular Surgery | ID | |
| - | MO | |
| Orthopedic Surgery | KS | |
| N E U R O L O G Y | MO | |
| - | MO |
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