Individual provider Active NPI

Timothy R O'Leary, M.D.

  • Radiation Oncology Physician
  • Festus, MO
National Provider Identifier
1700992294
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
102187 Issued in MO
Practice address
1350 US Highway 61
Festus, MO 63028-4124
Phone
(636) 933-0303
Fax
(636) 933-0293
NPI assigned
Aug 21, 2006
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 102187 MO Primary
Radiation Oncology Physician 2085R0001X 036095208 IL

Addresses

Primary practice location

1350 US Highway 61
Festus, MO 63028-4124

Mailing address

11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8210

Other identifiers 1

IdentifierTypeStateIssuer
204995302MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 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

Enrollment IDStateProvider typePAC IDDetails
I20100524000080 MO Practitioner - Radiation Oncology 0244245991 Reassigns benefits to 2 organizations
I20210713001205 IL Practitioner - Radiation Oncology 0244245991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Loyola University of Chicago, Stritch School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West County Radiological Group IncGroup PAC ID 8527966944, 105 clinicians

Practice addresses (Care Compare)

1350 US Hwy 61
Festus, MO 63028-4124
Phone (636) 933-0303

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6031

6836 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-9044

901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8250

901 Patients 1St Dr
Washington, MO 63090-4700
Phone (636) 231-6252

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.77 of 100Reported as group
Quality
86.95
Improvement activities
40
Cost
73.15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West County Radiological Group, Inc. Radiation Oncology CurrentSince Sep 1, 2018 Accepting new patients

Locations

6836 State Route 162
Maryville, IL 62062
Phone (618) 277-5882

15945 Clayton Rd
Ballwin, MO 63011
Phone (636) 256-5280

1350 US Highway 61
Crystal Cty, MO 63028
Phone (636) 931-3655

10050 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1688

11475 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141
Phone (314) 991-8200

607 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4283

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1700992294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11475 OLDE CABIN RD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417129",
            "telephone_number": "314-991-8210",
            "fax_number": "314-991-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284124",
            "telephone_number": "636-933-0303",
            "fax_number": "636-933-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "TIMOTHY",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "102187",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036095208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204995302",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.