Individual provider Active NPI

Rodrigo Ignacio Lopez-Costa, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1770712259
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2009011490 Issued in MO
Practice address
510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Jul 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2009011490 MO Primary

Addresses

Primary practice location

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016

Mailing address

3050 Montvale Dr
Ste a
Springfield, IL 62704-6924
Phone (217) 726-8096

Other practice location 1

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-0690

Other practice location 2

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-0690

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lopez-costar@clinicalradiologist.com Direct

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
I20130723001039 MO Practitioner - Diagnostic Radiology 7214178979 Reassigns benefits to 2 organizations
I20190501000158 IL Practitioner - Diagnostic Radiology 7214178979

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
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)

621 S New Ballas Rd
Saint Louis, MO 63141-8232
Phone (314) 251-5678

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052
  • Mercy Hospital Ada Hospital, Ada, OK, CCN 370020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009011490MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West County Radiological Group, Inc. Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Crawford Hospital District Current Accepting new patients
Lawrence County Memorial Hospital Past Accepting new patients
Elite Chiropractic Center LLC Past Accepting new patients

Locations

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

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

1500 Calvary Church Rd
Crystal Cty, MO 63028
Phone (636) 933-1818

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

630 NW Englewood Rd
Kansas City, MO 64118
Phone (816) 453-2700

621 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 432-0099

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

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

621 S New Ballas Rd
Ste 23
Saint Louis, MO 63141

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

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

851 E 5th St
Ste 100
Washington, MO 63090
Phone (636) 239-8258

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

3462 Hospital Rd
Healdton, OK 73438
Phone (580) 229-0701

300 Wanda St
Marietta, OK 73448
Phone (580) 276-2400

1000 S Byrd St
Tishomingo, OK 73460
Phone (580) 371-2327

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 and National Provider Directory roles.

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1770712259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MONTVALE DR",
            "address_2": "STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046924",
            "telephone_number": "217-726-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-0690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Lees Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641391236",
            "country_code": "US",
            "telephone_number": "816-404-0690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ-COSTA",
        "first_name": "RODRIGO",
        "middle_name": "IGNACIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2009011490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lopez-costar@clinicalradiologist.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "510 S Kingshighway Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "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.