Active NPI
Vilaas S. Shetty, M.D.
- Diagnostic Radiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2007007109
- Practice address
- 615 S New Ballas Rd
Saint Louis, MO 63141-8221 - Phone
- (314) 251-6031
- Fax
- (314) 251-6343
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2004015892 | MO | |
| Body Imaging Physician | 2085B0100X | 2007007109 | MO | |
| Diagnostic Neuroimaging (Radiology) Physician | 2085D0003X | 2007007109 | MO | |
| Neuroradiology Physician | 2085N0700X | 20070071090 | MO | |
| Neuroradiology Physician | 2085N0700X | 2007007109 | MO | |
| Pediatric Radiology Physician | 2085P0229X | 2007007109 | MO | |
| Diagnostic Ultrasound Physician | 2085U0001X | 2008020890 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | 2007007109 | MO | Primary |
Addresses
Primary practice location
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Mailing address
11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8200
Other practice location 1
901 E 5th St
Washington, MO 63090-3127
Phone (636) 239-8250
Other practice location 2
901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 390-1575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209616804 | Medicaid | MO |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Texas Southwestern Medical School at Dallas, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6031
Hospital & facility affiliations
- Mercy Hospital St Louis
- Mercy Hospital Washington
- Mercy Hospital Jefferson
- Mercy Hospital South
- Mercy Hospital Ardmore, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004015892 | MO | MD | Internal Medicine Physician |
| 2007007109 | MO | MD | Body Imaging Physician |
| 20070071090 | MO | MD | Neuroradiology Physician |
| 2008020890 | MO | MD | Diagnostic Ultrasound Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Cardinal Glennon Childrens Hospital | Body Imaging | Current | Accepting new patients |
| West County Radiological Group, Inc. | Neuroradiology | Current | Accepting new patients |
| SSM Health Care St. Louis | Internal Medicine | Current | Accepting new patients |
| SSM Health Care St Louis | Current | Accepting new patients | |
| SSM Cardinal Glennon Children'S Hospital | Current | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
630 NW Englewood Rd
Kansas City, MO 64118
Phone (816) 453-2700
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
701 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-6710
11475 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141
Phone (314) 991-8200
1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327
901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500
901 E 5th St
Washington, MO 63090
Phone (636) 239-8000
430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251
1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658
3462 Hospital Rd
Healdton, OK 73438
Phone (580) 229-0701
300 Wanda St
Marietta, OK 73448
Phone (580) 276-2400
1000 S Byrd St
Tishomingo, OK 73460
Phone (580) 371-2327
Organizations & group practices 5
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.
-
- Diagnostic Radiology Physician
- Saint Louis, MO
- NPI 1477500585
Neuroradiology
-
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Pediatrics Physician
- O Fallon, IL
- NPI 1174577670
Body Imaging, MO
-
- Pediatrics Physician
- Warrenton, MO
- NPI 1962573212
-
- Emergency Medicine Physician
- Saint Louis, MO
- NPI 1366400855
Internal Medicine
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Festus, MO
- NPI 1508859661
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
-
- General Acute Care Hospital
- Washington, MO
- NPI 1285664177
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
-
- General Acute Care Hospital
- Ardmore, OK
- NPI 1386741635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524441600000",
"number": "1164577540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11475 OLDE CABIN RD STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417129",
"telephone_number": "314-991-8200",
"fax_number": "314-991-8206"
},
{
"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": "314-251-6031",
"fax_number": "314-251-6343"
}
],
"practiceLocations": [
{
"address_1": "901 E 5th St",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "MO",
"postal_code": "630903127",
"country_code": "US",
"telephone_number": "636-239-8250",
"fax_number": "636-239-8271",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "901 Patients First Dr",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "MO",
"postal_code": "630904700",
"country_code": "US",
"telephone_number": "636-390-1575",
"fax_number": "636-390-9710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHETTY",
"first_name": "VILAAS",
"middle_name": "S.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-24",
"last_updated": "2018-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2004015892",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "MO",
"license": "2007007109",
"primary": false
},
{
"code": "2085D0003X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Neuroimaging",
"state": "MO",
"license": "2007007109",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "MO",
"license": "20070071090",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "MO",
"license": "2007007109",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "MO",
"license": "2007007109",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "MO",
"license": "2008020890",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2007007109",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "209616804",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.