NPIMap

Individual provider Active NPI

David W. Irvine, MD

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1386681138
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
106129 Issued in MO
Practice address
621 S New Ballas Rd
Suite 5015-B
Saint Louis, MO 63141-8232
Phone
(314) 567-5850
Fax
(314) 567-9169
NPI assigned
Jun 1, 2006
Last updated
Jan 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 106129 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 5015-B
Saint Louis, MO 63141-8232

Mailing address

PO Box 843438
Kansas City, MO 64184-3438
Phone (314) 567-5850

Other identifiers 9

IdentifierTypeStateIssuer
000000684662OtherMOANTHEM BCBS
1386681138OtherMOHUMANA
561508OtherMOHEALTHLINK
1386681138OtherMOCOVENTRY/GHP
615723400OtherMODEPARTMENT OF LABOR
209074004MedicaidMO
7308358OtherMOAETNA
273406555OtherMOMULTIPLAN/PHCS
273406555OtherMOTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000558 MO Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 7315028032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Saint Louis University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

15425 Manchester Rd
Suite 28
Ballwin, MO 63011-3077
Phone (636) 220-6969

621 S New Ballas Rd
Suite 3005B
Saint Louis, MO 63141-8266
Phone (314) 567-5850

7212 Balson Ave
Saint Louis, MO 63130-3001

851 E 5TH St
Suite 108
Washington, MO 63090-3128
Phone (636) 861-7870

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement55
Lower limb (leg) arthroscopy (minimally invasive joint repair)24
Upper limb (arm) arthroscopy (minimally invasive joint repair)49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106129MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC CurrentSince May 2, 2016 Accepting new patients
Mercy Clinic Children's Surgery, LLC CurrentSince Sep 5, 2020 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jan 1, 2015 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jan 1, 2015 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

621 S New Ballas Rd
Ste 5015B
Saint Louis, MO 63141
Phone (314) 251-7070

621 S New Ballas Rd
Ste 63B
Saint Louis, MO 63141
Phone (314) 251-3500

701 S New Ballas Rd
Ste 510
Saint Louis, MO 63141
Phone (314) 251-6710

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

Interoperability endpoints

  • Direct secure messaging: dirvine99553@directc.mercy.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1386681138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843438",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843438",
            "telephone_number": "314-567-5850",
            "fax_number": "314-567-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 5015-B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-567-5850",
            "fax_number": "314-567-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVINE",
        "first_name": "DAVID",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "106129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000684662",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1386681138",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "561508",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY/GHP",
            "identifier": "1386681138",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "615723400",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209074004",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7308358",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN/PHCS",
            "identifier": "273406555",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "273406555",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.