Individual provider Active NPI

Cristina Ivette Olivas Chacon, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1477903672
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2025036598 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6031
Fax
(314) 251-6343
NPI assigned
Jun 17, 2016
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 2025036598 MO
Diagnostic Radiology Physician 2085R0202X 2025036598 MO Primary
Diagnostic Radiology Physician 2085R0202X 45807 OK
Diagnostic Radiology Physician 2085R0202X D90924 MD

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NH, MA, TX, MO5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20210607001275 MD Practitioner - Diagnostic Radiology 8820385412 Reassigns benefits to 1 organization
I20221111000684 NH Practitioner - Diagnostic Radiology 8820385412 Reassigns benefits to 1 organization
I20221121000794 MA Practitioner - Diagnostic Radiology 8820385412 Reassigns benefits to 7 organizations
I20240619000191 TX Practitioner - Diagnostic Radiology 8820385412 Reassigns benefits to 1 organization
I20251007001069 MO Practitioner - Diagnostic Radiology 8820385412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West County Radiological Group IncGroup PAC ID 8527966944, 105 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025036598MOMDBody Imaging Physician
D90924MDMDDiagnostic Radiology Physician
45807OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 13, 2022 Accepting new patients
Brigham & Womens Physicians Organization Inc Body Imaging CurrentSince Mar 1, 2023 Accepting new patients
Johns Hopkins University Body Imaging CurrentSince Jul 1, 2021 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince Mar 6, 2023 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2021 Accepting new patients
West County Radiological Group, Inc. Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients
Cooley Dickinson Hospital Inc Current Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Oct 1, 2022 Accepting new patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Mar 1, 2023 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients
Hampshire Pathologists, Inc. Current Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Oct 13, 2022 Accepting new patients
Johns Hopkins University Current Accepting new patients
Cooley Dickinson Hospital Inc CurrentSince Mar 6, 2023 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

75 Francis St
Boston, MA 02115

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-0165

541 Main St
Ste 201
South Weymouth, MA 02190
Phone (781) 335-4815

12 College Hwy
Southampton, MA 01073
Phone (413) 527-1105

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

600 N Wolfe St
Baltimore, MD 21287

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

6201 Greenleigh Ave
Fl 2
Middle River, MD 21220
Phone (410) 933-2704

11475 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141
Phone (314) 991-8200

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

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

30 Tuscan Blvd
Salem, NH 03079
Phone (857) 282-8100

Interoperability endpoints

  • Direct secure messaging: olivaschacon.cristina.nsmc@direct.partners.masshiway.net

Organizations & group practices 16

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.

View all 16

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1477903672",
    "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": [],
    "basic": {
        "last_name": "OLIVAS CHACON",
        "first_name": "CRISTINA",
        "middle_name": "IVETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MO",
            "license": "2025036598",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2025036598",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "45807",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D90924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.