MODERN VASCULAR OF ST LOUIS LLC – NPI #1972106391
Radiology

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Health Care Provider Taxonomy Code for Radiology

MODERN VASCULAR OF ST LOUIS LLC is a radiologist located in CREVE COEUR, MO. NPPES has assigned the NPI number 1972106391 to MODERN VASCULAR OF ST LOUIS LLC on November 18, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2085R0204X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Vascular & Interventional Radiology

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MODERN VASCULAR OF ST LOUIS LLC below.

NPI Profile for
MODERN VASCULAR OF ST LOUIS LLC

NPI Number
1972106391
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MODERN VASCULAR OF ST LOUIS LLC
Primary location
641 N NEW BALLAS RD
CREVE COEUR, MO 63141-6713
Phone: (314) 648-0101 Fax: (314) 899-2715
Mailing address
26500 AGOURA RD STE 102-587
CALABASAS, CA 91302-1952
Phone: (818) 880-8605 Fax: (818) 579-7916
Organization Subpart
No
Authorized Official
YURY GAMPEL
CEO
Phone: (818) 880-8605
Updated
Certification Date
Nov 18, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0204X
- Radiology / Vascular & Interventional Radiology (Primary)
2471V0106X
- Radiologic Technologist / Vascular-Interventional Technology Radiologic Technologist

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.