Mrudula Penta, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2025021480 Issued in MO

Practice address

300 First Capital Drive
St Charles, MO 63301

Phone

(636) 947-5444

Fax

(636) 947-5259

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, MO2 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 2

Specialty

Diagnostic Radiology

Education

Stanford University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiologic Imaging Consultants LLPGroup PAC ID 4587652748, 16 clinicians

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
• Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpenta352467@hisp.ehr.sutterhealth.org

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.

• Radiologic Imaging Consultants, LLP

  • Diagnostic Radiology Physician
  • St Charles, MO
  • NPI 1871689505
  Medicare reassignment Care Compare group NPD
• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  Medicare reassignment Care Compare group NPD
• County of San Mateo

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• California Advanced Imaging Medical Associates Inc

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1881646909
  Medicare reassignment
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• County of San Mateo

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Doctors Resources Company, LLC

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1659416907
  NPD
• Metro Imaging, LLC

  • Diagnostic Radiology Physician
  • Creve Coeur, MO
  • NPI 1760578496
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish St Peters Hospital Inc

  • General Acute Care Hospital
  • Saint Peters, MO
  • NPI 1144238908
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1568670917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 COMPASS POINT DRIVE",
            "city": "ST CHARLES",
            "state": "MO",
            "postal_code": "63301",
            "telephone_number": "636-947-4480",
            "fax_number": "636-947-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FIRST CAPITAL DRIVE",
            "city": "ST CHARLES",
            "state": "MO",
            "postal_code": "63301",
            "telephone_number": "636-947-5444",
            "fax_number": "636-947-5259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S San Mateo Dr",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944013805",
            "country_code": "US",
            "telephone_number": "650-696-4515",
            "fax_number": "650-696-4637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 W 39th Ave",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944034364",
            "country_code": "US",
            "telephone_number": "650-573-2681",
            "fax_number": "650-573-2122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENTA",
        "first_name": "MRUDULA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A130188",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2025021480",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A130188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200161282",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Rose Peine
• Kailey Pellerito
• Diane Menke Pence, LMHC, LPC
• Michaele Mary Penkoske, M. D.
• Kaitlin Renee Pennington, PLPC
• Perez Family Chiropractic LLC
• Elizabeth Perez, D.C.
• Perinatal Wellness Institute, LLC
• John Craig Perlmutter, M.D.
• Patricia J Perotti, R.D., L.D

• Diagnostic Radiology Physician in St Charles, MO
• Providers in St Charles, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.

Verify at the official NPI Registry.