Individual provider Active NPI

Matthew G Mutch, MD

  • Colon & Rectal Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1669498887
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
106142 Issued in MO
Practice address
1044 N Mason Rd
Div Surg Colon/Rectal, Ste 310
Saint Louis, MO 63141-6431
Phone
(314) 454-7177
Fax
(888) 425-7946
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 106142 MO
Colon & Rectal Surgery Physician 208C00000X 106142 MO Primary

Addresses

Primary practice location

1044 N Mason Rd
Div Surg Colon/Rectal, Ste 310
Saint Louis, MO 63141-6431

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-7177

Other identifiers 1

IdentifierTypeStateIssuer
205822604MedicaidMO

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 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
I20040701000028 MO Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5991782799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Washington University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 273-7373

1 Barnes Jewish Hospital PLZ
Suite 200
Saint Louis, MO 63110-1003
Phone (314) 273-7373

1044 N Mason Rd
Medical Office 4
Saint Louis, MO 63141-6310
Phone (314) 362-2280

12634 Olive Blvd
Saint Louis, MO 63141-6337
Phone (314) 273-7373

5201 Mid America PLZ
Suite 2300
Saint Louis, MO 63129-0002
Phone (314) 273-7373

5225 Mid America PLZ
Saint Louis, MO 63129-0002
Phone (314) 286-2500

660 S Euclid Ave
Campus Box 8109
St Louis, MO 63110-1624
Phone (314) 362-7841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy67
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106142MOMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnes Jewish Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Saint Louis Connectcare Colon & Rectal Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmutch162522@direct.carenet.org
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1669498887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-7177",
            "fax_number": "888-425-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N MASON RD",
            "address_2": "DIV SURG COLON/RECTAL, STE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416431",
            "telephone_number": "314-454-7177",
            "fax_number": "888-425-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCH",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "106142",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MO",
            "license": "106142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205822604",
            "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": "1044 N Mason Rd",
            "address_2": "Div Surg Colon/Rectal, Ste 310",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416431",
            "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.