Active NPI
Jay Patrick Nelson, MD
- Diagnostic Radiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 2022019192
- Practice address
- 615 S New Ballas Rd
Saint Louis, MO 63141-8221 - Phone
- (314) 251-6031
- Fax
- (314) 251-6343
- NPI assigned
- Mar 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 40628 | OK | |
| Diagnostic Radiology Physician | 2085R0202X | 111377 | GA | |
| Diagnostic Radiology Physician | 2085R0202X | 2022019192 | MO | Primary |
| Neuroradiology Physician | 2085N0700X | 0101288049 | VA |
Addresses
Primary practice location
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Mailing address
11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8210
Other practice location 1
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone (703) 523-0611
Other practice location 2
743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, SC, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Missouri, Columbia School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- East Cooper Physician Group LLC
Practice addresses (Care Compare)
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6031
880 Island Park Dr
Unit 230
Daniel Island, SC 29492-2902
Phone (843) 380-9330
930 Wynhaven LN
Ballwin, MO 63011-2938
Phone (843) 881-0100
Hospital & facility affiliations
- Mercy Hospital St Louis
- Mercy Hospital South
- Mercy Hospital Jefferson
- Mercy Hospital Washington
- Mercy Hospital Ardmore, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.77 of 100
- Quality
- 86.95
- Improvement activities
- 40
- Cost
- 73.15
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101288049 | VA | MD | Neuroradiology Physician |
| 111377 | GA | MD | Diagnostic Radiology Physician |
| 2022019192 | MO | MD | Diagnostic Radiology Physician |
| 40628 | OK | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracl, LLC | Current | Accepting new patients | |
| West County Radiological Group, Inc. | Neuroradiology | Current | Accepting new patients |
| Washington University | Neuroradiology | Current | Accepting new patients |
| East Cooper Physician Group LLC | Current | Accepting new patients | |
| East Cooper Physician Group LLC | Current | Accepting new patients |
Locations
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
630 NW Englewood Rd
Kansas City, MO 64118
Phone (816) 453-2700
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177
660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809
510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900
11475 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141
Phone (314) 991-8200
701 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-6710
1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327
901 E 5th St
Washington, MO 63090
Phone (636) 239-8000
880 Island Park Dr
Unit 230
Daniel Island, SC 29492
Phone (843) 380-9330
851 Leonard Fulghum Dr
Ste 101
Mt Pleasant, SC 29464
Phone (843) 884-2133
2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200
Organizations & group practices 7
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.
-
- Diagnostic Radiology Physician
- Saint Louis, MO
- NPI 1477500585
Neuroradiology
-
- Multi-Specialty Clinic/Center
- Rolla, MO
- NPI 1205304300
-
- Internal Medicine Physician
- Daniel Island, SC
- NPI 1861253981
-
- Family Medicine Physician
- Columbus, GA
- NPI 1326749417
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Festus, MO
- NPI 1508859661
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
-
- General Acute Care Hospital
- Washington, MO
- NPI 1285664177
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
-
- General Acute Care Hospital
- Ardmore, OK
- NPI 1386741635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773705600000",
"number": "1477085520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11475 OLDE CABIN RD STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417129",
"telephone_number": "314-991-8210",
"fax_number": "314-991-8206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S NEW BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418221",
"telephone_number": "314-251-6031",
"fax_number": "314-251-6343"
}
],
"practiceLocations": [
{
"address_1": "2300 Opitz Blvd",
"address_purpose": "LOCATION",
"city": "Woodbridge",
"state": "VA",
"postal_code": "221913311",
"country_code": "US",
"telephone_number": "703-523-0611",
"fax_number": "703-670-2089",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "743 Spring St NE",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "GA",
"postal_code": "305013715",
"country_code": "US",
"telephone_number": "770-219-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON",
"first_name": "JAY",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-29",
"last_updated": "2026-03-17",
"certification_date": "2026-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OK",
"license": "40628",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "GA",
"license": "111377",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2022019192",
"primary": true
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "VA",
"license": "0101288049",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.