Individual provider Active NPI

Vincent Michael Mellnick, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1295918019
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2011004799 Issued in MO
Practice address
510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Dec 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 2011004799 MO Primary

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 1

IdentifierTypeStateIssuer
205563802MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20110505000665 MO Practitioner - Diagnostic Radiology 2668657669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at Houston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
Miracl LLCGroup PAC ID 4587908041, 96 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 362-7000

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

3009 N Ballas Rd
Saint Louis, MO 63131-2322
Phone (314) 996-5170

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 Hospital Hospital, Saint Louis, MO, CCN 260032
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Diagnostic Radiology CurrentSince Jun 1, 2011 Accepting new patients
Miracl, LLC CurrentSince Dec 24, 2018 Accepting new patients

Locations

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900

Interoperability endpoints

  • Direct secure messaging: vmellnick154458@direct.carenet.org

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 8

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": "1197676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1295918019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "address_2": "DEPT RADIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLNICK",
        "first_name": "VINCENT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-15",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2011004799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205563802",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "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.