Individual provider Active NPI

Miriam B Rodin, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1154484673
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2007030792 Issued in MO
Practice address
5701 Delmar Blvd
Saint Louis, MO 63112-2617
Phone
(314) 367-7848
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2007030792 MO
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036076819 IL
Internal Medicine Physician 207R00000X 2007030792 MO Primary

Addresses

Primary practice location

5701 Delmar Blvd
Saint Louis, MO 63112-2617

Mailing address

1008 S Spring Ave FL 2
Saint Louis, MO 63110-2520
Phone (314) 977-8462

Other practice location 1

1402 S Grand Blvd Rm 238
Division of Geriatric Medicine
Saint Louis, MO 63104-1004
Phone (314) 977-8462

Other practice location 2

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 977-8462

Other identifiers 1

IdentifierTypeStateIssuer
036076819MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mrodin236978@direct-ehr.ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20071219000305 MO Practitioner - Geriatric MedicinePractitioner - Internal Medicine 5193768828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
2007030792MOMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

1402 S Grand Blvd
Rm 238
Saint Louis, MO 63104
Phone (314) 977-8462

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

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: miriam.rodin.p1@direct.phcenters.nextgenshare.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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1154484673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-8462",
            "fax_number": "314-771-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122617",
            "telephone_number": "314-367-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 S Grand Blvd Rm 238",
            "address_2": "Division of Geriatric Medicine",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-977-8462",
            "fax_number": "314-771-8575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-977-8462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODIN",
        "first_name": "MIRIAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2007030792",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036076819",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007030792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036076819",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrodin236978@direct-ehr.ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mrodin236978@direct-ehr.ssmhc.com",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.