Individual provider Active NPI

Jonathan D Root, M.D.

  • Diagnostic Radiology Physician
  • Saint Charles, MO
National Provider Identifier
1033139696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R8F12 Issued in MO
Practice address
300 First Capitol Drive
St Charles, MO 63301
Phone
(636) 947-5444
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R8F12 MO Primary
Diagnostic Radiology Physician 2085R0202X 036086602 IL

Addresses

Primary practice location

300 First Capitol Drive
St Charles, MO 63301

Mailing address

220 Compass Point Dr
Saint Charles, MO 63301-4405
Phone (636) 947-4480

Other identifiers 4

IdentifierTypeStateIssuer
203143300MedicaidMO
036086602MedicaidIL
300102466OtherMORAILROAD MEDICARE
300102481OtherMORAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000081 MO Practitioner - Diagnostic Radiology 0547220535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Temple University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiologic Imaging Consultants LLPGroup PAC ID 4587652748, 16 clinicians
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

100 Medical PLZ
Lake Saint Louis, MO 63367-1366
Phone (636) 625-5303

1475 Kisker Rd
Suite 160
Saint Charles, MO 63304-8786
Phone (636) 498-7800

1598 W Meyer Rd
SSM Health Wentzville Outpatient Center
Wentzville, MO 63385-3653
Phone (636) 332-8042

300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone (636) 947-5444

500 Medical Dr
Wentzville, MO 63385-3421
Phone (636) 327-1140

711 Veterans Memorial Pkwy
Saint Charles, MO 63303-2106
Phone (636) 669-2418

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036086602ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Oct 1, 2025 Accepting new patients
SSM Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Radiologic Imaging Consultants, LLP Diagnostic Radiology CurrentSince Mar 1, 1999 Accepting new patients
SSM St. Joseph Health Center PastSince Apr 30, 2003 Accepting new patients
Metro Imaging, LLC Diagnostic Radiology Past Accepting new patients
Boonslick Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

2305 Georgia St
Louisiana, MO 63353
Phone (573) 754-4584

220 Compass Point Dr
Saint Charles, MO 63301
Phone (636) 947-4480

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

164 Professional Pkwy
#164
Troy, MO 63379
Phone (636) 528-0392

Interoperability endpoints

  • Direct secure messaging: jroot13032@direct-ehr-ssmhc.com

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033139696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 COMPASS POINT DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014405",
            "telephone_number": "636-947-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FIRST CAPITOL DRIVE",
            "city": "ST CHARLES",
            "state": "MO",
            "postal_code": "63301",
            "telephone_number": "636-947-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R8F12",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036086602",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203143300",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086602",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300102466",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300102481",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.