Individual provider Active NPI

Mark Anatoly Rivkin, D.O.

  • Neurological Surgery Physician
  • Festus, MO
National Provider Identifier
1427373265
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2014038760 Issued in MO
Practice address
1400 US Highway 61
Festus, MO 63028-4100
Phone
(636) 933-1000
NPI assigned
Apr 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2014038760 MO Primary

Addresses

Primary practice location

1400 US Highway 61
Festus, MO 63028-4100

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

1390 US Highway 61 Ste N1500
Festus, MO 63028-4137
Phone (636) 717-6720

Other practice location 2

10012 Kennerly Rd Ste 400
Saint Louis, MO 63128-2197
Phone (314) 543-5999

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mrivkin147282@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
I20150805008035 MO Practitioner - Neurosurgery 9032335443 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Kansas City College of Medicine and Surgery, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians
Ste Genevieve County Memorial HospitalGroup PAC ID 3274432802, shared by 9 NPIs, 74 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Saint Louis, MO 63128-2197

10050 Kennerly Rd
Suite 25200
Saint Louis, MO 63128-2106
Phone (314) 525-4440

1390 US Hwy 61
Suite N1500
Festus, MO 63028-4137
Phone (636) 717-6720

255 Boderman
Bloomsdale, MO 63627-9099
Phone (573) 483-9492

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

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
Spinal fusion125
Laminectomy or laminotomy (partial removal of spine bones)56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014038760MOMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Jul 29, 2024 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

3619 Richardson Square Dr
Ste 170
Arnold, MO 63010
Phone (636) 717-6776

1390 US Highway 61
Ste N1500
Crystal Cty, MO 63028
Phone (636) 933-5055

10012 Kennerly Rd
Ste 400
Saint Louis, MO 63128
Phone (314) 525-1258

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

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

Organizations & group practices 4

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 5

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1427373265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1390 US Highway 61 Ste N1500",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284137",
            "country_code": "US",
            "telephone_number": "636-717-6720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10012 Kennerly Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282197",
            "country_code": "US",
            "telephone_number": "314-543-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVKIN",
        "first_name": "MARK",
        "middle_name": "ANATOLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2014038760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrivkin147282@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mrivkin147282@direct-ehr-ssmhc.com",
            "address_1": "1055 Bowles Ave",
            "address_2": "Suite 200",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630262308",
            "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": "1055 Bowles Ave",
            "address_2": "Suite 200",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630262308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.