NPIMap

Individual provider Active NPI

Pawel Tadeusz Dyk, M.D.

  • Radiation Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1578791000
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2014007075 Issued in MO
Practice address
3015 N Ballas Rd
Oncology Suite
Saint Louis, MO 63131-2329
Phone
(314) 996-5729
NPI assigned
Jun 23, 2009
Last updated
Oct 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 2014007075 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Oncology Suite
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Oncology Suite
Saint Louis, MO 63131-2329
Phone (314) 996-5729

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20140724002146 MO Practitioner - Radiation Oncology 3476782293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Saint Louis University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Baptist Physician Services LLCGroup PAC ID 0446294342, 25 clinicians

Practice addresses (Care Compare)

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
72.08
Promoting interoperability
100
Improvement activities
20
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014007075MOMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Baptist Physician Services LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: pdyk244320@direct.carenet.org

Organizations & group practices 1

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 7

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1578791000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "address_2": "ONCOLOGY SUITE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "address_2": "ONCOLOGY SUITE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYK",
        "first_name": "PAWEL",
        "middle_name": "TADEUSZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2014007075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "address_2": "Oncology Suite",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "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.