Individual provider Active NPI

Ronald L Palmer, MD

  • Diagnostic Radiology Physician
  • Bridgeton, MO
National Provider Identifier
1578597290
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R5B08 Issued in MO
Practice address
12303 Depaul Dr
Depaul Health Center
Bridgeton, MO 63044
Phone
(314) 344-6350
NPI assigned
Jul 10, 2006
Last updated
Feb 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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 R5B08 MO Primary

Addresses

Primary practice location

12303 Depaul Dr
Depaul Health Center
Bridgeton, MO 63044

Mailing address

502 Earth City Expressway
Ste 121
Earth City, MO 63045
Phone (314) 770-2133

Other identifiers 1

IdentifierTypeStateIssuer
201778701MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070807000499 MO Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9931290830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ernst Radiology Clinic, IncGroup PAC ID 2961488366, 20 clinicians

Practice addresses (Care Compare)

3440 Depaul LN
Bridgeton, MO 63044-3545
Phone (314) 739-0924

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Institute at Depaul Past Accepting new patients

Organizations & group practices 2

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 5

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1578597290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EARTH CITY EXPRESSWAY",
            "address_2": "STE 121",
            "city": "EARTH CITY",
            "state": "MO",
            "postal_code": "63045",
            "telephone_number": "314-770-2133",
            "fax_number": "314-770-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DEPAUL DR",
            "address_2": "DEPAUL HEALTH CENTER",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-344-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "RONALD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R5B08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201778701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.