Benjamin Edward Northrup, MD
Individual provider Active NPI Diagnostic Radiology Physician · Saint Louis, MO
NPI 1124256359 · NPPES record last updated Apr 17, 2025
Key facts
- NPI
- 1124256359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 2012003483 (MO)
- Practice address
- 510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016 - Phone
- (314) 362-7200
- Fax
- (314) 747-4189
- NPI assigned
- Jun 25, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Washington University
Miracl LLC
Practice addresses (Care Compare)
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 362-7000
10 Hospital Dr
Saint Peters, MO 63376-1659
Phone (636) 916-9000
1000 W 10TH St
Phelps Health
Rolla, MO 65401-2905
Phone (573) 364-9000
11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone 31436272001
1225 Graham Rd
Florissant, MO 63031-8012
Phone 31436272001
12634 Olive Blvd
Saint Louis, MO 63141-6337
Phone (314) 996-8000
14532 S Outer 40 Rd
Chesterfield, MO 63017-5705
Phone (314) 514-3500
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000
4500 Forest Park Ave
Saint Louis, MO 63108-2114
Phone (314) 362-7111
4921 Parkview PL
Saint Louis, MO 63110-1032
Phone (314) 454-7921
510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
5201 Mid America PLZ
Saint Louis, MO 63129-0002
Phone (314) 286-0909
5225 Mid America PLZ
Saint Louis, MO 63129-0002
Phone (314) 286-2500
751 Sappington Bridge Rd
Sullivan, MO 63080-2354
Phone (573) 468-4189
Hospital & facility affiliations
- Barnes-Jewish West County Hospital
- Barnes Jewish Hospital
- Missouri Baptist Medical Center
- Phelps County Regional Medical Center
- Christian Hospital Northeast
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140429001074 | MO | Practitioner - Diagnostic Radiology | 3072741834 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracl, LLC | Current |
Accepting new patients | |
| Northland Radiology, Inc. | Diagnostic Radiology | Current |
Accepting new patients |
Locations
2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900
510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2012003483 | MO | Yes |
Addresses
Primary practice location
510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-7200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200011966 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Other providers in Saint Louis, MO
- Northland Hearing Center, Inc.
- Northland Hearing Center, Inc.
- Northland Hearing Center, Inc.
- Northlight Development LP
- Northpoint Radiation Center GP, LLC
- Megan Elizabeth Northrup
- Northside Oral Surgery CNT Donald M Suggs Ddspc
- Northstar Injury Care LLC
- Northview Village, Inc.
- Caleb Norton
All providers in Saint Louis, MO · Diagnostic Radiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.