Individual provider Active NPI

Tonya Michelle Martin-Dunlap, MD

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1881850600
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2019026085 Issued in MO
Practice address
10050 Kennerly Rd Ste 1500
Saint Louis, MO 63128-2198
Phone
(314) 525-1545
Fax
(314) 525-1685
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E-7623 AR
Surgery Physician 208600000X 2019026085 MO Primary

Addresses

Primary practice location

10050 Kennerly Rd Ste 1500
Saint Louis, MO 63128-2198

Mailing address

10050 Kennerly Rd Ste 1500
Saint Louis, MO 63128-2198
Phone (314) 525-1545

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
I20110817000342 MO Practitioner - General SurgeryPractitioner - Surgical OncologyPractitioner - Other (Physician) 8325217821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of New York at Buffalo School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic St Louis Cancer and Breast Institute LLCGroup PAC ID 9739240037, 10 clinicians

Practice addresses (Care Compare)

10050 Kennerly Rd
Suite 1500
Saint Louis, MO 63128-2106
Phone (314) 525-1545

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy26
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-7623ARMDSurgery Physician
2019026085MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic St. Louis Cancer and Breast Institute, LLC CurrentSince Aug 26, 2024 Accepting new patients
Mercy Clinic Burn and Plastic Surgery, LLC PastSince Aug 25, 2024 Accepting new patients

Locations

15945 Clayton Rd
Ste 120
Ballwin, MO 63011
Phone (636) 256-5000

10050 Kennerly Rd
Ste 1500
Saint Louis, MO 63128
Phone (314) 525-1545

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 3

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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1881850600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 KENNERLY RD STE 1500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282198",
            "telephone_number": "314-525-1545",
            "fax_number": "314-525-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 KENNERLY RD STE 1500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282198",
            "telephone_number": "314-525-1545",
            "fax_number": "314-525-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-DUNLAP",
        "first_name": "TONYA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-7623",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2019026085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.