Individual provider Active NPI

Jason Isaac Margolis, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Louis, MO
National Provider Identifier
1437315702
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2011037753 Issued in MO
Practice address
621 South New Ballas Road
Suite 16 a
St. Louis, MO 63141
Phone
(314) 251-6725
Fax
(314) 251-6726
NPI assigned
Aug 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2011037753 MO Primary

Addresses

Primary practice location

621 South New Ballas Road
Suite 16 a
St. Louis, MO 63141

Mailing address

621 South New Ballas Road
Suite 16 a
St. Louis, MO 63141
Phone (314) 251-6725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000717 VA Practitioner - Oral Surgery 6103074257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Oregon Health & Sciences Univ School of Dentistry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roanoke Oral Surgery IncGroup PAC ID 1456314681, 4 clinicians

Practice addresses (Care Compare)

6035 Peters Creek Rd
Roanoke, VA 24019-4029
Phone (540) 362-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011037753MOMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jul 16, 2014 Accepting new patients
Roanoke Oral Surgery, Inc. Oral and Maxillofacial Surgery CurrentSince Jul 1, 2013 Accepting new patients
Carilion Medical Center CurrentSince Jul 16, 2014 Accepting new patients
Michael W. Noble, DMD, PC Oral and Maxillofacial Surgery Past Accepting new patients
Vision Surgical Arts, LLC Past Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

6035 Peters Creek Rd
Roanoke, VA 24019
Phone (540) 362-5900

3229 Brandon Ave SW
Roanoke, VA 24018
Phone (540) 362-5900

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1437315702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SOUTH NEW BALLAS ROAD",
            "address_2": "SUITE 16 A",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-6725",
            "fax_number": "314-251-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SOUTH NEW BALLAS ROAD",
            "address_2": "SUITE 16 A",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-6725",
            "fax_number": "314-251-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGOLIS",
        "first_name": "JASON",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2011037753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.