Active NPI
Gino Joseph Vricella, MD
- Urology Physician
- Saint Louis, MO
National Provider Identifier
1548464431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 2013017657
- Practice address
- 1 Childrens PL
Div Surg Urology Ped, Ste 2a
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6034
- Fax
- (314) 454-2876
- NPI assigned
- Jun 13, 2007
- Last updated
- Nov 15, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 2013017657 | MO | Primary |
| Pediatric Urology Physician | 2088P0231X | 2013017657 | MO |
Addresses
Primary practice location
1 Childrens PL
Div Surg Urology Ped, Ste 2a
Saint Louis, MO 63110-1002
Mailing address
660 S Euclid Ave
MSC 8242-22-02
Saint Louis, MO 63110-1010
Phone (314) 362-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200006355 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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 KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Missouri, Columbia School of Medicine, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11300 Corporate Ave
Lenexa, KS 66219-1348
11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013017657 | MO | MD | Pediatric Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas University Physicians Inc | Urology | Current | Accepting new patients |
| Kansas University Physicians Inc | Current | Accepting new patients | |
| The Children's Mercy Hospital | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Kansas City, KS
- NPI 1003858333
-
- Cardiovascular Disease Physician
- Kansas City, KS
- NPI 1407637291
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
- Children's Hospital
- Overland Park, KS
- NPI 1154400232
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Children's Hospital
- Kansas City, MO
- NPI 1366515488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1548464431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "MSC 8242-22-02",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-8200",
"fax_number": "314-367-5016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "DIV SURG UROLOGY PED, STE 2A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6034",
"fax_number": "314-454-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VRICELLA",
"first_name": "GINO",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MO",
"license": "2013017657",
"primary": true
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "MO",
"license": "2013017657",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200006355",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "1 Childrens Pl",
"address_2": "Div Surg Urology Ped, Ste 2A",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101002",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 15, 2021; 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.