Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JUSTIN TYLER DUMRONGKULRAKSA MD
NPI 1568040475
Radiology - Diagnostic Radiology in Saint Louis, MO

Q: What is Justin Dumrongkulraksa's NPI number?

The NPI number for Justin Dumrongkulraksa is 1568040475. It was assigned to this individual provider in the NPPES registry on March 31, 2021.

Q: What is Justin Dumrongkulraksa's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Active since March 31, 2021PECOS Enrolled

510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGY, SAINT LOUIS, MO 63110(314) 362-7200(314) 747-4189 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 6, 2026, Jul 19, 2021, Mar 31, 2021 (3 updates tracked since 2021).

On this page

About Dr. Justin Tyler Dumrongkulraksa Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JUSTIN TYLER DUMRONGKULRAKSA MD (NPI 1568040475) is an individual diagnostic radiology provider in Saint Louis, Missouri, licensed in Missouri (2023012240) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568040475

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. JUSTIN TYLER DUMRONGKULRAKSACredential: MD

Location Address510 S KINGSHIGHWAY BLVD, DEPT RADIOLOGYSaint Louis, MO 63110-1016

Mailing AddressPo Box 7412011Chicago, IL 60674-2011 · (314) 362-7200 · Fax (314) 747-4189

Phone(314) 362-7200

Fax(314) 747-4189

Sole ProprietorNo

Enumeration DateMarch 31, 2021

Last NPPES UpdateJuly 6, 20263 updates tracked since enumeration

NPPES CertifiedJuly 19, 2021

✔ NPI 1568040475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in MO · 2023012240

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

510 S KINGSHIGHWAY BLVD, Saint Louis, MO 63110

Open in Google Maps ↗

Other Identifiers 1

Medicaid200112134MO

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Justin Tyler Dumrongkulraksa Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63110 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$69.50 typical visit price

range $17.76 – $137.92

Typical copayment $17.37 (range $4.44 – $34.48)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BENJAMIN LEE MD

Radiology (Neuroradiology)

510 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63110

St. Louis City (314) 362-7092

DR. ADRIAN ALBERTO SANCHEZ MD