Individual provider Active NPI

Deryk L McDowell, M.D.

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1356486179
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2005006002 Issued in MO
Practice address
625 S New Ballas Rd
Suite 2030
Saint Louis, MO 63141-8253
Phone
(314) 251-1700
Fax
(314) 251-1701
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2005006002 MO Primary

Addresses

Primary practice location

625 S New Ballas Rd
Suite 2030
Saint Louis, MO 63141-8253

Mailing address

136 Reavis PL
Webster Groves, MO 63119-4034
Phone (314) 961-3498

Other identifiers 2

IdentifierTypeStateIssuer
1356486179MedicaidMO
P00776606OtherMORAILROAD MEDICARE

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
I20090820000593 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0143281170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Southern Illinois University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

625 S New Ballas Rd
Suite 2015
Saint Louis, MO 63141-8253
Phone (314) 251-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dmcdowell101695@directc.mercy.net

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356486179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 REAVIS PL",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631194034",
            "telephone_number": "314-961-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "address_2": "SUITE 2030",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418253",
            "telephone_number": "314-251-1700",
            "fax_number": "314-251-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "DERYK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2005006002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356486179",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00776606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.