Jesse Daya Vrecenak, MD
Individual provider Active NPI Pediatric Surgery Physician · Saint Louis, MO
NPI 1710185392 · NPPES record last updated Apr 17, 2025
Key facts
- NPI
- 1710185392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Surgery Physician 2086S0120X
- License
- 2017025963 (MO)
- Practice address
- 1 Childrens PL
Div Surg Ped, Ste 2a
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6022
- Fax
- (866) 422-8308
- NPI assigned
- Jul 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Perelman School of Med at the University of Pennsylvania, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Washington University
Practice addresses (Care Compare)
1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 454-6000
Hospital & facility affiliations
- St Louis Childrens Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.2 of 100
- Quality
- 71.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170818000108 | MO | Practitioner - General Surgery | 7416229943 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017025963 | MO | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington University | Current |
Accepting new patients | |
| Washington University | Current |
Accepting new patients | |
| Washington University | Past | Accepting new patients | |
| St. Louis Children'S Hospital | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1 Childrens Pl
Ste A
Saint Louis, MO 63110
Phone (314) 454-6034
1 Childrens Pl
Ste 2D
Saint Louis, MO 63110
Phone (314) 454-6300
1 Childrens Pl
Ste 6110
Saint Louis, MO 63110
1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076
5114 Mid America Plz
Ste 3A
Saint Louis, MO 63129
Phone (314) 454-6120
660 S Euclid Ave
#C
Saint Louis, MO 63110
660 S Euclid Ave
#8235
Saint Louis, MO 63110
Phone (314) 454-6070
1 Childrens Pl
Ste 2A
Saint Louis, MO 63110
Phone (314) 454-6022
Interoperability endpoints
- jvrecenak151841@direct.carenet.org
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 2017025963 | MO | Yes |
Addresses
Primary practice location
1 Childrens PL
Div Surg Ped, Ste 2a
Saint Louis, MO 63110-1002
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200044965 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Other providers in Saint Louis, MO
- Collin J Voyles
- Vpa PC
- Vpa PC
- Vpa PC
- Vpa PC
- Edward Jim Vredenburgh III
- Timothy Joseph Vreeland
- Gino Joseph Vricella
- Stanley Vriezelaar
- Maxwell Jedediah Vruwink
All providers in Saint Louis, MO · Pediatric Surgery Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.