Individual provider Active NPI

Robert J Gresick Jr., MD

  • Diagnostic Radiology Physician
  • Bridgeton, MO
National Provider Identifier
1992746937
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R1F56 Issued in MO
Practice address
12303 Depaul Dr
Depaul Health Center
Bridgeton, MO 63044
Phone
(314) 344-6350
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 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 036065440 IL
Diagnostic Radiology Physician 2085R0202X R1F56 MO Primary

Addresses

Primary practice location

12303 Depaul Dr
Depaul Health Center
Bridgeton, MO 63044

Mailing address

502 Earth City Expressway
Suite 121
Earth City, MO 63045
Phone (314) 770-2133

Other identifiers 1

IdentifierTypeStateIssuer
202672101MedicaidMO

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
I20070116000493 MO Practitioner - Diagnostic RadiologyPractitioner - General Surgery 0345249132 Reassigns benefits to 4 organizations
I20220816001451 IL Practitioner - Diagnostic Radiology 0345249132 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ernst Radiology Clinic IncGroup PAC ID 2264829639, 16 clinicians
Ernst Radiology Clinic, IncGroup PAC ID 2961488366, 20 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

12303 Depaul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6350

Hospital & facility affiliations

  • Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
  • SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
  • SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Aug 21, 2025 Accepting new patients
Ernst Radiology Clinic, Inc Diagnostic Radiology CurrentSince Dec 31, 1991 Accepting new patients
Specialt MRI, LLC Diagnostic Radiology CurrentSince Aug 29, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Ernst Radiology Clinic, Inc Diagnostic Radiology CurrentSince Apr 1, 2022 Accepting new patients
USA Radiology Management Solutions LLC Diagnostic Radiology CurrentSince Oct 6, 2019 Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

12255 De Paul Dr
Ste 737
Bridgeton, MO 63044

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

16091 Swingley Ridge Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 728-2222

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

946 E Reed St
Hayti, MO 63851
Phone (573) 359-3408

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

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

Interoperability endpoints

  • Direct secure messaging: rgresick22479@direct-ehr-ssmhc.com

Organizations & group practices 7

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 5

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1992746937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EARTH CITY EXPRESSWAY",
            "address_2": "SUITE 121",
            "city": "EARTH CITY",
            "state": "MO",
            "postal_code": "63045",
            "telephone_number": "314-770-2133",
            "fax_number": "314-770-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DEPAUL DR",
            "address_2": "DEPAUL HEALTH CENTER",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-344-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESICK",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036065440",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R1F56",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202672101",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.