Individual provider Active NPI

Madi Khalil Mikhayel, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1114238979
Registry record updated Jun 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2010019840 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6930
Fax
(314) 251-4288
NPI assigned
Jun 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2010019840 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

615 S New Ballas Rd
Saint Louis, MO 63141-8221

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
I20160811002669 MO Practitioner - Diagnostic Radiology 9335444009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

1225 S Grand Blvd
Saint Louis, MO 63104-1016

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8208

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
  • SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010019840MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients

Locations

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: mmikhayel19103@direct-ehr-ssmhc.com

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277596800000",
    "number": "1114238979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6930",
            "fax_number": "314-251-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAYEL",
        "first_name": "MADI",
        "middle_name": "KHALIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-27",
        "last_updated": "2010-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2010019840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.