Mark D Wittry, MD is a medicare enrolled "Nuclear Medicine" physician in Saint Louis, Missouri. He went to Rush Medical College Of Rush University and graduated in 1983 and has 41 years of diverse experience with area of expertise as Nuclear Medicine. He is a member of the group practice West County Radiological Group Inc and his current practice location is
615 S New Ballas Rd, Dept Of Nuclear Medicine, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 251-6465.
Mark D Wittry is licensed to practice in Missouri (license number R5F02) 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 1497721088.
Physician's Profile
| Full Name | Mark D Wittry |
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| Gender | Male |
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| Speciality | Nuclear Medicine |
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| Experience | 41 Years |
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| Location | 615 S New Ballas Rd, Saint Louis, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mark D Wittry attended and graduated from Rush Medical College Of Rush University in 1983
NPI Data:
- NPI Number: 1497721088
- Provider Enumeration Date: 02/24/2006
- Last Update Date: 02/22/2016
Medicare PECOS Information:
- PECOS PAC ID: 1850327594
- Enrollment ID: I20050713000843
Medical Identifiers
Medical identifiers for Mark D Wittry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497721088 | NPI | - | NPPES |
| 202885919 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0202X | Radiology - Diagnostic Radiology | R5F02 (Missouri) | Secondary |
| 207U00000X | Nuclear Medicine | R5F02 (Missouri) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | R5F02 (Missouri) | Secondary |
| 207UN0902X | Nuclear Medicine - Nuclear Imaging & Therapy | R5F02 (Missouri) | Secondary |
| 207U00000X | Nuclear Medicine | 036069181 (Illinois) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| West County Radiological Group Inc | 8527966944 | 80 |
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. Mark D Wittry allows following entities to bill medicare on his behalf.
| Entity Name | Mercy Clinic Springfield Communities |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245277631
PECOS PAC ID: 7416865845
Enrollment ID: O20031104000060 |
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| Entity Name | West County Radiological Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477500585
PECOS PAC ID: 8527966944
Enrollment ID: O20031223000255 |
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| Entity Name | West County Radiological Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477500585
PECOS PAC ID: 8527966944
Enrollment ID: O20040326000180 |
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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. Mark D Wittry 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 Address | Practice Location Address |
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Mark D Wittry, MD
11475 Olde Cabin Rd, Suite 200,
Saint Louis, MO 63141-7128
Ph: (314) 991-8200 | Mark D Wittry, MD
615 S New Ballas Rd, Dept Of Nuclear Medicine,
Saint Louis, MO 63141-8221
Ph: (314) 251-6465 |
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