Active NPI
Robert J Gresick Jr., MD
- Diagnostic Radiology Physician
- Bridgeton, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- R1F56
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202672101 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
- SSM Health St Mary'S Hospital -Centralia
- SSM St Clare Health Center
- SSM Health Depaul Hospital St Louis
- SSM Health St. Mary'S Hospital - Jefferson City
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Ernst Radiology Clinic, Inc | Diagnostic Radiology | Current | Accepting new patients |
| Specialt MRI, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Ernst Radiology Clinic, Inc | Diagnostic Radiology | Current | Accepting new patients |
| USA Radiology Management Solutions LLC | Diagnostic Radiology | Current | 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
- 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.
-
- Diagnostic Radiology Physician
- Rolla, MO
- NPI 1689091076
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Fenton, MO
- NPI 1811740301
Diagnostic Radiology
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
-
- General Acute Care Hospital
- Fenton, MO
- NPI 1851496152
-
- General Acute Care Hospital
- Jefferson City, MO
- NPI 1518065523
-
- General Acute Care Hospital
- Mount Vernon, IL
- NPI 1609897339
-
- General Acute Care Hospital
- Centralia, IL
- NPI 1083617245
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.