| Washington University Department Of Orthopedic Surgery | |
|
660 S Euclid Ave Campus Box 8233 Saint Louis MO 63110-1010 | |
| (314) 286-1937 | |
| (314) 286-1877 |
| Full Name | Washington University Department Of Orthopedic Surgery |
|---|---|
| Speciality | Clinic/Center |
| Location | 660 S Euclid Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Cathy L Eghigian (DIRECTOR, CREDENTIALING OPERATIONS) |
| Authorized Official Contact | 3149350770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington University Department Of Orthopedic Surgery 7425 Forsyth Blvd Campus Box 8221 Saint Louis MO 63105-2171 Ph: (314) 935-0770 | Washington University Department Of Orthopedic Surgery 660 S Euclid Ave Campus Box 8233 Saint Louis MO 63110-1010 Ph: (314) 286-1937 |
| NPI Number | 1679516033 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 12/06/2007 |
| Medicare PECOS PAC ID | 9830008770 |
|---|---|
| Medicare Enrollment ID | O20040420000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679516033 | NPI | - | NPPES |
| 6460194 | Other | MO | SPECIAL HEALTH CARE NEEDS |
| 92215230 | Other | IL | BLUE SHIELD |
| 3834 | Other | MO | GHP MASTER VENDOR |
| 0255860003 | Other | MO | DME MEDICARE GROUP |
| 09-01999 | Other | MO | UHC GROUP NUMBER |
| 673341 | Other | MO | AETNA HMO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Laura L Meyers |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184667529 PECOS PAC ID: 5092619742 Enrollment ID: I20031124000556 |
| Provider Name | Christi L Abeln |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023034253 PECOS PAC ID: 1951395136 Enrollment ID: I20040412000571 |
| Provider Name | Tabitha S Stith |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1265422000 PECOS PAC ID: 9436143104 Enrollment ID: I20040414000674 |
| Provider Name | Adam J Labore |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1720004955 PECOS PAC ID: 6305826744 Enrollment ID: I20040724000429 |
| Provider Name | Mark E Halstead |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1598783227 PECOS PAC ID: 4486634714 Enrollment ID: I20040726000632 |
| Provider Name | Devyani M Hunt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1053339770 PECOS PAC ID: 1850363235 Enrollment ID: I20040806000694 |
| Provider Name | Robert L Barrack |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871511501 PECOS PAC ID: 4688636822 Enrollment ID: I20041101000206 |
| Provider Name | Julia Partin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1245218106 PECOS PAC ID: 8325087653 Enrollment ID: I20050427000227 |
| Provider Name | Jacob Maciej Buchowski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831115146 PECOS PAC ID: 1052341336 Enrollment ID: I20050816001025 |
| Provider Name | John Paul Metzler |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1235156712 PECOS PAC ID: 9335166727 Enrollment ID: I20051025000691 |
| Provider Name | Heidi Prather |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1326066960 PECOS PAC ID: 7012939390 Enrollment ID: I20051230000029 |
| Provider Name | Jay Donovan Keener |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689692642 PECOS PAC ID: 2769450402 Enrollment ID: I20060829000381 |
| Provider Name | Rimma Ruvinskaya |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1538185855 PECOS PAC ID: 5698870558 Enrollment ID: I20070420000480 |
| Provider Name | Ryan M Nunley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164568887 PECOS PAC ID: 8426156662 Enrollment ID: I20070612000072 |
| Provider Name | Sandra E Klein |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619036878 PECOS PAC ID: 1153420898 Enrollment ID: I20070621000303 |
| Provider Name | Robert H Brophy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316070410 PECOS PAC ID: 9638279508 Enrollment ID: I20070706000061 |
| Provider Name | Alexandre Rene Carter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235343534 PECOS PAC ID: 7416039003 Enrollment ID: I20080205000364 |
| Provider Name | Ryan Calfee |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1548212764 PECOS PAC ID: 0143222711 Enrollment ID: I20080626000444 |
| Provider Name | Richard H Gelberman |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1093732521 PECOS PAC ID: 1456450345 Enrollment ID: I20090223000539 |
| Provider Name | Scott J Luhmann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548286859 PECOS PAC ID: 9638226921 Enrollment ID: I20090402000037 |
| Provider Name | Jeremy James Mccormick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265585111 PECOS PAC ID: 3274606488 Enrollment ID: I20090708000083 |
| Provider Name | Matthew Vernon Smith |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1457567430 PECOS PAC ID: 6204992688 Enrollment ID: I20090709000129 |
| Provider Name | Chi Tsai Tang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437273554 PECOS PAC ID: 2961557533 Enrollment ID: I20090903000068 |
| Provider Name | Charles A Goldfarb |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1871511352 PECOS PAC ID: 1658411129 Enrollment ID: I20091214000379 |
| Provider Name | Martin I Boyer |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1891711024 PECOS PAC ID: 1951441443 Enrollment ID: I20091214000553 |
| Provider Name | Matthew J. Matava |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1588680706 PECOS PAC ID: 2668514969 Enrollment ID: I20100125000840 |
| Provider Name | Jeffrey E Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275551699 PECOS PAC ID: 7315089471 Enrollment ID: I20100127000856 |
| Provider Name | Joe E Gordon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558389288 PECOS PAC ID: 4587706650 Enrollment ID: I20100127000874 |
| Provider Name | Keith H Bridwell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063438281 PECOS PAC ID: 6608919675 Enrollment ID: I20100130000219 |
| Provider Name | John C Clohisy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972521516 PECOS PAC ID: 5698818664 Enrollment ID: I20100130000228 |
| Provider Name | Matthew Barrett Dobbs |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205853710 PECOS PAC ID: 0042353575 Enrollment ID: I20100205000709 |
| Provider Name | Ken Yamaguchi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376561001 PECOS PAC ID: 4284779190 Enrollment ID: I20100303000642 |
| Provider Name | Douglas J Mcdonald |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639196173 PECOS PAC ID: 9133256761 Enrollment ID: I20100429000971 |
| Provider Name | Perry L Schoenecker |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093733503 PECOS PAC ID: 5890824395 Enrollment ID: I20100521000076 |
| Provider Name | Lukas Peter Zebala |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780779124 PECOS PAC ID: 3678607322 Enrollment ID: I20100817000326 |
| Provider Name | Christopher M Mcandrew |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336354760 PECOS PAC ID: 2163575853 Enrollment ID: I20100909000755 |
| Provider Name | Paul Sherman Lux |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326041997 PECOS PAC ID: 2668514480 Enrollment ID: I20110209001092 |
| Provider Name | Corri A Payton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780718247 PECOS PAC ID: 4880870500 Enrollment ID: I20110513000660 |
| Provider Name | Frank E Krajczar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922002484 PECOS PAC ID: 8921286485 Enrollment ID: I20110705000036 |
| Provider Name | Aaron Chamberlain |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770665333 PECOS PAC ID: 4880864081 Enrollment ID: I20110825000587 |
| Provider Name | Timothy T Yau |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1275794729 PECOS PAC ID: 2163580291 Enrollment ID: I20110914000727 |
| Provider Name | Lindley B Wall |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1114108719 PECOS PAC ID: 2163690009 Enrollment ID: I20120824000028 |
| Provider Name | Michele R Mueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285979195 PECOS PAC ID: 1254578891 Enrollment ID: I20130520000076 |
| Provider Name | Mark L Miller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053576215 PECOS PAC ID: 0547493546 Enrollment ID: I20140428001280 |
| Provider Name | Jeffrey Jerome Nepple |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730386541 PECOS PAC ID: 8426281809 Enrollment ID: I20140509001439 |
| Provider Name | Cara Cipriano |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578725537 PECOS PAC ID: 9032357959 Enrollment ID: I20141230000649 |
| Provider Name | Regis J Okeefe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497797757 PECOS PAC ID: 7618030271 Enrollment ID: I20150309000384 |
| Provider Name | David M Brogan |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1710115712 PECOS PAC ID: 0143354472 Enrollment ID: I20150811004600 |
| Provider Name | Christopher J Dy |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1477712933 PECOS PAC ID: 5890001689 Enrollment ID: I20150824001615 |
| Provider Name | Scott A Simpson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043535438 PECOS PAC ID: 8729394549 Enrollment ID: I20150825002826 |
| Provider Name | Karen D Holtmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568600344 PECOS PAC ID: 2961634225 Enrollment ID: I20150904001028 |
| Provider Name | Muyibat A Adelani |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396908042 PECOS PAC ID: 7113169632 Enrollment ID: I20150904001496 |
| Provider Name | Catherine L Dezort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649505561 PECOS PAC ID: 2668625872 Enrollment ID: I20150914000417 |
| Provider Name | Munish C Gupta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417948571 PECOS PAC ID: 9335213784 Enrollment ID: I20150916002893 |
| Provider Name | Ljiljana Bogunovic |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1821227406 PECOS PAC ID: 7517182355 Enrollment ID: I20150921002600 |
| Provider Name | Stacey F Scrogin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780049171 PECOS PAC ID: 4789989641 Enrollment ID: I20160302000085 |
| Provider Name | Alexander Aleem |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326369265 PECOS PAC ID: 1951530294 Enrollment ID: I20160615000626 |
| Provider Name | Brian Kelly |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023244522 PECOS PAC ID: 6305003476 Enrollment ID: I20160615000996 |
| Provider Name | Anna N Miller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477764504 PECOS PAC ID: 7810020419 Enrollment ID: I20160729001166 |
| Provider Name | Kelly Eileen Estes |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1881960060 PECOS PAC ID: 6204065048 Enrollment ID: I20160920002714 |
| Provider Name | Pooya Hosseinzadeh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437363660 PECOS PAC ID: 0941499511 Enrollment ID: I20161013000371 |
| Provider Name | Cecilia Pascual Garrido |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235446543 PECOS PAC ID: 8729269097 Enrollment ID: I20170227001190 |
| Provider Name | Charles Lawrie |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720354806 PECOS PAC ID: 1254601305 Enrollment ID: I20170721001354 |
| Provider Name | Mahshid Mohseni |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1356634612 PECOS PAC ID: 7315185717 Enrollment ID: I20170804000816 |
| Provider Name | Nathan Parke Olafsen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447516778 PECOS PAC ID: 2769707652 Enrollment ID: I20170912001584 |
| Provider Name | Devin R Willis |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1295175057 PECOS PAC ID: 7012143449 Enrollment ID: I20170913002736 |
| Provider Name | Beth Ann Dalrymple-woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194950816 PECOS PAC ID: 6204102171 Enrollment ID: I20171019002976 |
| Provider Name | Jeremy A Hartman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184064057 PECOS PAC ID: 4587885553 Enrollment ID: I20171108000751 |
| Provider Name | Laura C Depalma |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710129630 PECOS PAC ID: 2567601479 Enrollment ID: I20180208002065 |
| Provider Name | Kayla Portwood Luker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730531518 PECOS PAC ID: 8325300650 Enrollment ID: I20180326000428 |
| Provider Name | Owoicho Adogwa |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1154681542 PECOS PAC ID: 4587955844 Enrollment ID: I20180717001707 |
| Provider Name | Adam Wegner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538428859 PECOS PAC ID: 6507115532 Enrollment ID: I20180823002066 |
| Provider Name | Craig A Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902240211 PECOS PAC ID: 4587913512 Enrollment ID: I20180823002167 |
| Provider Name | Nicholas Andrew Pallotta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023351129 PECOS PAC ID: 1759630783 Enrollment ID: I20180823002252 |
| Provider Name | Mostafa H El Dafrawy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285900118 PECOS PAC ID: 8628226032 Enrollment ID: I20180823002412 |
| Provider Name | Harold S Ellsworth |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215370648 PECOS PAC ID: 4486956869 Enrollment ID: I20180823002536 |
| Provider Name | Jeremy John Gebhart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174967715 PECOS PAC ID: 2961751953 Enrollment ID: I20180824000604 |
| Provider Name | Jonathan Robinson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730475005 PECOS PAC ID: 4688923683 Enrollment ID: I20180824001109 |
| Provider Name | Siddhant Kumar Mehta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558702498 PECOS PAC ID: 5799001574 Enrollment ID: I20180827001566 |
| Provider Name | Jonathan D Carrier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982018115 PECOS PAC ID: 7618278029 Enrollment ID: I20180829004093 |
| Provider Name | Timothy Michael Lonergan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346683059 PECOS PAC ID: 1153567870 Enrollment ID: I20180905003939 |
| Provider Name | Nicholas James Grimm |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982048450 PECOS PAC ID: 5496032120 Enrollment ID: I20181010001695 |
| Provider Name | Susan Mary Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316458870 PECOS PAC ID: 6507118841 Enrollment ID: I20181015001294 |
| Provider Name | Dayna Evans Bronson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821452533 PECOS PAC ID: 0749548824 Enrollment ID: I20181022001923 |
| Provider Name | Marschall B Berkes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568622702 PECOS PAC ID: 9436402476 Enrollment ID: I20181022002056 |
| Provider Name | Keith M Patten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518443225 PECOS PAC ID: 8426301854 Enrollment ID: I20181031002413 |
| Provider Name | Christina Jean Carey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386120376 PECOS PAC ID: 7315281771 Enrollment ID: I20181212000619 |
| Provider Name | Abby Ling-lee Cheng |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1922443092 PECOS PAC ID: 6002110103 Enrollment ID: I20181213000640 |
| Provider Name | Nartana N Mehta |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265937346 PECOS PAC ID: 6204172786 Enrollment ID: I20190104002005 |
| Provider Name | Jonathon D Backus |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548587900 PECOS PAC ID: 4284863507 Enrollment ID: I20190513001458 |
| Provider Name | Nicole V. Messenger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689058521 PECOS PAC ID: 5890008486 Enrollment ID: I20190725003828 |
| Provider Name | Benjamin M Zmistowski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265850309 PECOS PAC ID: 0244534121 Enrollment ID: I20190827001531 |
| Provider Name | Daniel Quinones |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093135774 PECOS PAC ID: 2264736347 Enrollment ID: I20190828000224 |
| Provider Name | Elizabeth Lieberman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578982567 PECOS PAC ID: 0941428783 Enrollment ID: I20190828001299 |
| Provider Name | Michael J Reiter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285051482 PECOS PAC ID: 7719200682 Enrollment ID: I20190830001162 |
| Provider Name | Gregory M Decker |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437564614 PECOS PAC ID: 0345460747 Enrollment ID: I20190905001820 |
| Provider Name | Rajin Shahriar |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679815260 PECOS PAC ID: 7810252855 Enrollment ID: I20190905002020 |
| Provider Name | Tyler Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508270877 PECOS PAC ID: 8820215577 Enrollment ID: I20190905002113 |
| Provider Name | Erik James Hansen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821418690 PECOS PAC ID: 9830319946 Enrollment ID: I20190905002310 |
| Provider Name | Travis Winston |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477963361 PECOS PAC ID: 4385943331 Enrollment ID: I20190905003025 |
| Provider Name | Sean Michael Rider |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790198646 PECOS PAC ID: 4981821204 Enrollment ID: I20190905003043 |
| Provider Name | Daniel Rubio |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639598212 PECOS PAC ID: 3779894803 Enrollment ID: I20190905003139 |
| Provider Name | Matthew Lawrence Goodwin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770927337 PECOS PAC ID: 1850614736 Enrollment ID: I20190916002319 |
| Provider Name | Deeptee Jain |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497198642 PECOS PAC ID: 3678865375 Enrollment ID: I20190919001444 |
| Provider Name | Christopher Andrew Anthony |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548673106 PECOS PAC ID: 1850517160 Enrollment ID: I20190920000275 |
| Provider Name | Duncan Scott Mchardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366098808 PECOS PAC ID: 0547591430 Enrollment ID: I20191007003276 |
| Provider Name | Sara Ranae Kellahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871144832 PECOS PAC ID: 0840623898 Enrollment ID: I20191204002310 |
| Provider Name | Collin P Magilligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194377325 PECOS PAC ID: 4385076967 Enrollment ID: I20200713000182 |
| Provider Name | Lauren Maccormick Tatman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982014130 PECOS PAC ID: 5193029916 Enrollment ID: I20200804001258 |
| Provider Name | Lee Montgomery Sasala |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619359106 PECOS PAC ID: 4385069699 Enrollment ID: I20200804001455 |
| Provider Name | Brian L Dial |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962897504 PECOS PAC ID: 9537584859 Enrollment ID: I20200804002000 |
| Provider Name | Caleb W Grote |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689054553 PECOS PAC ID: 9830495514 Enrollment ID: I20200804003119 |
| Provider Name | Wesley H Mayes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205220100 PECOS PAC ID: 1557677994 Enrollment ID: I20200804003276 |
| Provider Name | Justin Marc Rabinowitz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417338773 PECOS PAC ID: 8123317922 Enrollment ID: I20200804003588 |
| Provider Name | Patrick Thomas Sweeney |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275922064 PECOS PAC ID: 9537464581 Enrollment ID: I20200805000604 |
| Provider Name | Shalin Shreyaskumar Patel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316328826 PECOS PAC ID: 6103134143 Enrollment ID: I20200805001699 |
| Provider Name | Floreana Kebaish |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972914760 PECOS PAC ID: 6800104563 Enrollment ID: I20200805001847 |
| Provider Name | Emmalynn Sigrist |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346632551 PECOS PAC ID: 7911284641 Enrollment ID: I20200811003926 |
| Provider Name | Erin Adams Hofer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932581683 PECOS PAC ID: 3476860172 Enrollment ID: I20200824002893 |
| Provider Name | Jeffrey M Hills |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154708196 PECOS PAC ID: 8921300658 Enrollment ID: I20200911001428 |
| Provider Name | Kayla Elizabeth Daniel |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1750743233 PECOS PAC ID: 1456645621 Enrollment ID: I20201106001756 |
| Provider Name | Kimberly Ann Bartosiak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356722276 PECOS PAC ID: 7315251535 Enrollment ID: I20210923001959 |
| Provider Name | Zachary I Meyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891177150 PECOS PAC ID: 5991018574 Enrollment ID: I20211026001659 |
| Provider Name | Charles Patrick Hannon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417339375 PECOS PAC ID: 9537459441 Enrollment ID: I20211105001640 |
| Provider Name | Derrick Michael Knapik |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306253133 PECOS PAC ID: 9436574522 Enrollment ID: I20211116002594 |
| Provider Name | Dennis Ian English |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790103901 PECOS PAC ID: 7810287703 Enrollment ID: I20211116002784 |
| Provider Name | Ilya Bendich |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225419617 PECOS PAC ID: 3870861776 Enrollment ID: I20211229002034 |
| Provider Name | Megan S Knetzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790301232 PECOS PAC ID: 4688065659 Enrollment ID: I20211230000161 |
| Provider Name | Diana M Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295187987 PECOS PAC ID: 2961795836 Enrollment ID: I20220722001073 |
| Provider Name | Dustin Kyle Baker |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528411857 PECOS PAC ID: 2466730023 Enrollment ID: I20220725002132 |
| Provider Name | Laviel A Fernandez |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194259416 PECOS PAC ID: 7719368554 Enrollment ID: I20220725003147 |
| Provider Name | Hunter Welburn Hood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164953485 PECOS PAC ID: 3577944347 Enrollment ID: I20220726000628 |
| Provider Name | Kirk Bonner |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1245726660 PECOS PAC ID: 8527440320 Enrollment ID: I20220726002137 |
| Provider Name | Ryan Jonathan Cone |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548793730 PECOS PAC ID: 8426325267 Enrollment ID: I20220726002714 |
| Provider Name | Michael Anthony Boeving |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1275038853 PECOS PAC ID: 6305194804 Enrollment ID: I20220727000531 |
| Provider Name | Daniel Rene Layon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043746589 PECOS PAC ID: 8224308614 Enrollment ID: I20220801000705 |
| Provider Name | Jeffrey R Hill |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922528496 PECOS PAC ID: 7012399165 Enrollment ID: I20220805000676 |
| Provider Name | Andrew Paul Thome |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326426925 PECOS PAC ID: 8527499573 Enrollment ID: I20220805000683 |
| Provider Name | Taryn Leroy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538690375 PECOS PAC ID: 4587933478 Enrollment ID: I20220810001078 |
| Provider Name | Julio Jose Jauregui |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689108326 PECOS PAC ID: 1658646112 Enrollment ID: I20220909001560 |
| Provider Name | Maksim Aleksandrovich Shlykov |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104346337 PECOS PAC ID: 0941572770 Enrollment ID: I20220926001591 |
| Provider Name | Cody J Sanderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275064560 PECOS PAC ID: 6204100183 Enrollment ID: I20221004003328 |
| Provider Name | Marie Theresa Morris |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235589342 PECOS PAC ID: 4688042427 Enrollment ID: I20221129000183 |
| Provider Name | Ryan Everett Doyel |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1336526458 PECOS PAC ID: 4688979990 Enrollment ID: I20230427002502 |
| Provider Name | Juliana Varela |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649526971 PECOS PAC ID: 8426413261 Enrollment ID: I20230428002405 |
| Provider Name | Kayla D Hambleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881375475 PECOS PAC ID: 4789046418 Enrollment ID: I20230814000147 |
| Provider Name | Andrea Rose Phinney |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790274488 PECOS PAC ID: 1254794175 Enrollment ID: I20230825000183 |
| Provider Name | Katherine Elizabeth Buesser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184118234 PECOS PAC ID: 6204299902 Enrollment ID: I20230829000953 |
| Provider Name | William Arthur Zuke |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972093250 PECOS PAC ID: 7911262217 Enrollment ID: I20230830000945 |
| Provider Name | Katherine Marie Caldwell |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1841750502 PECOS PAC ID: 7113380502 Enrollment ID: I20230901000857 |
| Provider Name | Katherine Lynn Mistretta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326543968 PECOS PAC ID: 7719340108 Enrollment ID: I20230901000996 |
| Provider Name | Arnaldo Martinez Rivera |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396292348 PECOS PAC ID: 1759744162 Enrollment ID: I20230901001802 |
| Provider Name | Andrea Boss Mccullough |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063073831 PECOS PAC ID: 5294198602 Enrollment ID: I20230901001862 |
| Provider Name | Tomas E Liskutin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770089005 PECOS PAC ID: 1759638315 Enrollment ID: I20230901001865 |
| Provider Name | David Peter Falk |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144710500 PECOS PAC ID: 7012370323 Enrollment ID: I20230901002310 |
| Provider Name | Diana G Douleh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467983148 PECOS PAC ID: 7214204767 Enrollment ID: I20230901002663 |
| Provider Name | John Clayton Fourni Clohisy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285164319 PECOS PAC ID: 7214209055 Enrollment ID: I20230905000180 |
| Provider Name | Melissa Anderson Wright |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255745576 PECOS PAC ID: 0648490482 Enrollment ID: I20230906001054 |
| Provider Name | Eric Joseph Sanders |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801390026 PECOS PAC ID: 2860738077 Enrollment ID: I20230907003879 |
| Provider Name | Joseph J Kromka |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811486376 PECOS PAC ID: 8426303595 Enrollment ID: I20230908001815 |
| Provider Name | Mark James Lambrechts |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477904472 PECOS PAC ID: 5092086488 Enrollment ID: I20230919001638 |
| Provider Name | Mitchel Robert Obey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366972580 PECOS PAC ID: 9032481833 Enrollment ID: I20230922002587 |
| Provider Name | John Rhodes Wickman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609372499 PECOS PAC ID: 5890149884 Enrollment ID: I20230925002563 |
| Provider Name | Blake Karlton Montgomery |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104270610 PECOS PAC ID: 0547662595 Enrollment ID: I20231002002030 |
| Provider Name | Andrew Michael Schneider |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053842807 PECOS PAC ID: 8426329186 Enrollment ID: I20231006002730 |
| Provider Name | Syed Ali Sina Adil |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467942953 PECOS PAC ID: 6800241464 Enrollment ID: I20231017002292 |
| Provider Name | Alyson Genee Dykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205422086 PECOS PAC ID: 3476901547 Enrollment ID: I20231129003680 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
Town And Country Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 | |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 | |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 | |
Victus Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 | |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
Dtg Ii Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3819 Tesson Ct, Saint Louis, MO 63123 Phone: 800-268-7713 Fax: 415-704-3294 |