NPIMap

Individual provider Active NPI

Brent T Allen, MD

  • Vascular Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1770513319
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
R2B05 Issued in MO
Practice address
555 N New Ballas Rd
Div Surg Vascular, Ste 265
Saint Louis, MO 63141-6825
Phone
(314) 991-4644
Fax
(866) 342-0133
NPI assigned
Jul 3, 2006
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X R2B05 MO Primary

Addresses

Primary practice location

555 N New Ballas Rd
Div Surg Vascular, Ste 265
Saint Louis, MO 63141-6825

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 991-4644

Other identifiers 1

IdentifierTypeStateIssuer
202398723MedicaidMO

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000764 MO Practitioner - Vascular Surgery 1254230212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Washington University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 362-5298

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
Varicose vein removal15
Leg revascularization (restoring blood flow)34
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Current Accepting new patients
Washington University CurrentSince Mar 1, 2023 Accepting new patients
Washington University CurrentSince Mar 1, 2023 Accepting new patients
Missouri Baptist Medical Center Past Accepting new patients
Suburban Surgical Associates, Inc. Past Accepting new patients

Locations

1050 W 10th St
Ste 500
Rolla, MO 65401
Phone (573) 308-1301

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

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

3023 N Ballas Rd
Ste 600D
Saint Louis, MO 63131
Phone (314) 567-7018

555 N New Ballas Rd
Ste 265
Saint Louis, MO 63141
Phone (314) 991-4644

660 S Euclid Ave
Saint Louis, MO 63110

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

Interoperability endpoints

  • Direct secure messaging: ballen11110@direct.carenet.org
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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 6

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1770513319",
    "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": "314-991-4644",
            "fax_number": "866-342-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N NEW BALLAS RD",
            "address_2": "DIV SURG VASCULAR, STE 265",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416825",
            "telephone_number": "314-991-4644",
            "fax_number": "866-342-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "BRENT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-04-15",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "R2B05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202398723",
            "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": "555 N New Ballas Rd",
            "address_2": "Div Surg Vascular, Ste 265",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416825",
            "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.