NPIMap

Individual provider Active NPI

Jared Koen, M.D.

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1841641164
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2021014025 Issued in MO
Practice address
3655 Vista Ave
Suite 116
Saint Louis, MO 63110-2539
Phone
(314) 268-5499
NPI assigned
Jun 28, 2016
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2021014025 MO Primary
Surgery Physician 208600000X 2016017305 MO

Addresses

Primary practice location

3655 Vista Ave
Suite 116
Saint Louis, MO 63110-2539

Mailing address

3655 Vista Ave
Suite 116
Saint Louis, MO 63110-2539
Phone (314) 268-5499

Other practice location 1

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210507002007 MO Practitioner - Diagnostic RadiologyPractitioner - Neurology 1850688011 Reassigns benefits to 9 organizations
I20240523004050 NJ Practitioner - Diagnostic Radiology 1850688011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Englewood Radiologic Group P aGroup PAC ID 6901852300, 131 clinicians
Fred Smeltzer MD and Associates IncGroup PAC ID 8921078304, 95 clinicians

Practice addresses (Care Compare)

12550 Heckenridge Dr
Rolla, MO 65401-8750
Phone (952) 595-1100

699 Canyon Pkwy
Branson, MO 65616-6275
Phone (952) 595-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Miracl, LLC CurrentSince Jul 1, 2021 Accepting new patients
SSM Health Care Group Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Radiology Associates of Ridgewood P a CurrentSince Jun 1, 2024 Accepting new patients
Fred Smeltzer MD & Associates Inc Diagnostic Radiology CurrentSince May 18, 2025 Accepting new patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince Sep 28, 2025 Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Ozarks Medical Center Diagnostic Radiology Past Accepting new patients

Locations

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-1320

3655 Vista Ave
Ste 116
Saint Louis, MO 63110
Phone (314) 268-5499

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

20 Franklin Tpke
Waldwick, NJ 07463
Phone (201) 445-3040

Interoperability endpoints

  • Direct secure messaging: jkoen198688@direct-ehr-ssmhc.com

Organizations & group practices 11

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 10

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1841641164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 VISTA AVE",
            "address_2": "SUITE 116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-268-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 VISTA AVE",
            "address_2": "SUITE 116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-268-5499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Minnesota Dr Ste 800",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554357915",
            "country_code": "US",
            "telephone_number": "952-595-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOEN",
        "first_name": "JARED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2021014025",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2016017305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.