Dr Ismael Perez Moreno, MD - Medicare Interventional Radiology in St. Louis, MO

Dr Ismael Perez Moreno, MD is a medicare enrolled "Radiology - Vascular & Interventional Radiology" physician in St. Louis, Missouri. He went to University Of California, Geffen School Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Interventional Radiology. He is a member of the group practice Advanced Radiology And Interventional Associates Inc and his current practice location is 3635 Vista At Grand, Desloge Towers, 2nd Floor, St. Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at (314) 268-5782.

Dr Ismael Perez Moreno is licensed to practice in California (license number A117180) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1679716278.

Contact Information

Dr Ismael Perez Moreno, MD
3635 Vista At Grand, Desloge Towers, 2nd Floor,
St. Louis, MO 63110
(314) 268-5782
(314) 268-5116



Physician's Profile

Full NameDr Ismael Perez Moreno
GenderMale
SpecialityInterventional Radiology
Experience20 Years
Location3635 Vista At Grand, St. Louis, Missouri
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Ismael Perez Moreno attended and graduated from University Of California, Geffen School Of Medicine in 2004
  NPI Data:
  • NPI Number: 1679716278
  • Provider Enumeration Date: 04/13/2009
  • Last Update Date: 02/12/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 9830354125
  • Enrollment ID: I20120712000343

Medical Identifiers

Medical identifiers for Dr Ismael Perez Moreno such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679716278NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology MT 184060 (Pennsylvania)Secondary
2085R0202XRadiology - Diagnostic Radiology C7-0004180 (Delaware)Secondary
2085R0204XRadiology - Vascular & Interventional Radiology 2013030321 (Missouri)Secondary
2085R0204XRadiology - Vascular & Interventional Radiology A117180 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Joseph's Medical Center Of StocktonStockton, CAHospital
Kaiser Foundation Hosp So SacramentoSacramento, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Advanced Radiology And Interventional Associates Inc216381644842

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ismael Perez Moreno allows following entities to bill medicare on his behalf.
Entity NameDignity Health Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700803418
PECOS PAC ID: 7810800661
Enrollment ID: O20031107000709

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Entity NameRegents Of The Univ Of Ca
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013906973
PECOS PAC ID: 3375456619
Enrollment ID: O20031111000892

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Entity NameCentral Valley Imaging Medical Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275523169
PECOS PAC ID: 8628064953
Enrollment ID: O20040422000783

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Entity NameKc Tan, M.d. Medical Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215394036
PECOS PAC ID: 2062719719
Enrollment ID: O20160324000980

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Entity NamePinnacle Sjir
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437705456
PECOS PAC ID: 9638500374
Enrollment ID: O20200512003087

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Entity NameAdvanced Radiology And Interventional Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669123626
PECOS PAC ID: 2163816448
Enrollment ID: O20220302002290

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ismael Perez Moreno is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Ismael Perez Moreno, MD
1680 Stronsay Ct,
Folsom, CA 95630-6224

Ph: (916) 501-1472
Dr Ismael Perez Moreno, MD
3635 Vista At Grand, Desloge Towers, 2nd Floor,
St. Louis, MO 63110

Ph: (314) 268-5782

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Radiology Doctors in St. Louis, MO

Dr. Robert Gordon Swanson, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 6420 Clayton Rd., St. Mary's Health Center, St. Louis, MO 63117
Phone: 314-768-8267    
Dr. Alan E Harris, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: Va St. Louis Medical Center, 915 North Grand Blvd., St. Louis, MO 63106
Phone: 314-652-4100    
Dr. Jeevin Shahi, MD
Radiology
Medicare: Medicare Enrolled
Practice Location: 3685 Vista Avenue, Center For Radiation Medicine, St. Louis, MO 63110
Phone: 314-257-7000    Fax: 314-268-5106
Dylan Jared Assael, MD
Radiology
Medicare: Medicare Enrolled
Practice Location: 1 Barnes-jewish Plaza, St. Louis, MO 63110
Phone: 314-362-5000    
Jeffrey Dines, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 615 South New Ballas, Typ, St. Louis, MO 63141
Phone: 314-251-6930    Fax: 314-251-4454
Dr. Thomas Ross Jr.,
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 1-a The Pines Court, St. Louis, MO 63141
Phone: 800-758-5120    Fax: 636-216-0101
Veena Kunigal, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: Center For Radiation Medicine, 3685 Vista Avenue, St. Louis, MO 63110
Phone: 314-577-8815    Fax: 314-268-5113

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