NPIMap

Individual provider Active NPI

Jerome Valentine Dwyer, M.D.

  • Specialist
  • Saint Louis, MO
National Provider Identifier
1477515047
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
3009 N Ballas Rd
Suite 202B
Saint Louis, MO 63131-2322
Phone
(314) 995-6839
Fax
(314) 995-6883
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

3009 N Ballas Rd
Suite 202B
Saint Louis, MO 63131-2322

Mailing address

451 Hammersmith Rd
Saint Louis, MO 63141-8603
Phone (314) 579-9232

Other identifiers 2

IdentifierTypeStateIssuer
203581707MedicaidMO
060024301OtherMOMEDICARE RAILROAD

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
I20100521000647 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 1557410628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Saint Louis University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3009 N Ballas Rd
Suite 202B
Saint Louis, MO 63131-2344
Phone (314) 995-6839

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Missouri Baptist Sullivan Hospital Hospital, Sullivan, MO, CCN 261337
  • Washington County Memorial Hospital Hospital, Potosi, MO, CCN 261308
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inderjit Singh MD Facp LLC Specialist Past Accepting new patients
Manzoor Tariq, Inc. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGEFAA/Endpoint/HGEFAA
  • Direct secure messaging: slcc.jeromedwyer@160793.advancedmd-direct.com

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 6

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1477515047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HAMMERSMITH RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418603",
            "telephone_number": "314-579-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "SUITE 202B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-995-6839",
            "fax_number": "314-995-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "JEROME",
        "middle_name": "VALENTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203581707",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060024301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.