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

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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, Permanente Medical Group 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

Map and Direction




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 Inc216381644844
Permanente Medical Group Inc89219102258376

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 NamePermanente Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710
Entity NameDignity Health Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700803418
PECOS PAC ID: 7810800661
Enrollment ID: O20031107000709
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
Entity NameCounty Of San Joaquin
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801830583
PECOS PAC ID: 6002703436
Enrollment ID: O20040301001287
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
Entity NameSan Joaquin Faculty Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225063761
PECOS PAC ID: 4082631395
Enrollment ID: O20051026000742
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
Entity NamePinnacle Sjir
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437705456
PECOS PAC ID: 9638500374
Enrollment ID: O20200512003087
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

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

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.