NPIMap

Individual provider Active NPI

Alyssa Kate Plouzek, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1487183893
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2022011623 Issued in MO
Practice address
510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Jun 8, 2017
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2022011623 MO Primary

Addresses

Primary practice location

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016

Mailing address

660 S Euclid Ave
CB 8131
Saint Louis, MO 63110-1010
Phone (314) 362-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20230731000434 NE Practitioner - Diagnostic Radiology 1557631892 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plains Radiology Services LLCGroup PAC ID 1850453432, 61 clinicians
Great Plains Radiology LLCGroup PAC ID 2062310899, 39 clinicians
Grand Island Radiology Associates PCGroup PAC ID 7719978261, 44 clinicians
Grand Island Clinic IncGroup PAC ID 9931181526, 22 clinicians

Practice addresses (Care Compare)

3610 Richmond Cir
Suite 100
Grand Island, NE 68803-3910
Phone (308) 398-6400

711 N Custer Ave
Gic Imaging
Grand Island, NE 68803-4311
Phone (308) 382-1100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Plains Radiology Services LLC Diagnostic Radiology CurrentSince Aug 1, 2023 Accepting new patients
Heartland Imaging Center of Hastings LLC Diagnostic Radiology CurrentSince Aug 28, 2023 Accepting new patients
Great Plains Radiology LLC Diagnostic Radiology CurrentSince Aug 1, 2023 Accepting new patients
Grand Island Imaging Center LLC Diagnostic Radiology CurrentSince Sep 25, 2023 Accepting new patients
Grand Island Clinic Inc Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Grand Island Radiology Associates PC Diagnostic Radiology CurrentSince Aug 1, 2023 Accepting new patients
Grand Island Clinic Inc Past Accepting new patients

Locations

2444 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-1100

3610 Richmond Cir
Ste 100
Grand Island, NE 68803
Phone (308) 382-6856

711 N Custer Ave
Grand Island, NE 68803
Phone (308) 381-1781

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

Organizations & group practices 8

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.

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1487183893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8131",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "address_2": "DEPT RADIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOUZEK",
        "first_name": "ALYSSA",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2022011623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.