Individual provider Active NPI

Carlos Javier Guevara, MD

  • Vascular & Interventional Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1861529299
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
2013015484 Issued in MO
Practice address
12855 N 40 Dr Ste 205
Saint Louis, MO 63141-8670
Phone
(314) 255-2204
Fax
(866) 623-8346
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 2013015484 MO Primary
Diagnostic Radiology Physician 2085R0202X 2013015484 MO

Addresses

Primary practice location

12855 N 40 Dr Ste 205
Saint Louis, MO 63141-8670

Mailing address

12855 N 40 Dr Ste 205
Saint Louis, MO 63141-8670
Phone (314) 255-2204

Other practice location 1

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone (314) 362-7200

Other identifiers 1

IdentifierTypeStateIssuer
200004294MedicaidMO

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000080 MO Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0143462903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Duke University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone 31436272001

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
Leg revascularization (restoring blood flow)197

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013015484MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miracl, LLC CurrentSince Aug 15, 2019 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Aug 15, 2019 Accepting new patients

Locations

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

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900

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

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

Interoperability endpoints

  • Direct secure messaging: cguevara1016558@direct.carenet.org

Organizations & group practices 2

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 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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1861529299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418670",
            "telephone_number": "314-255-2204",
            "fax_number": "866-623-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418670",
            "telephone_number": "314-255-2204",
            "fax_number": "866-623-8346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101016",
            "country_code": "US",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "CARLOS",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MO",
            "license": "2013015484",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2013015484",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200004294",
            "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": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "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.