Individual provider Active NPI

Stephen J Johans, M.D.

  • Neurological Surgery Physician
  • O Fallon, IL
National Provider Identifier
1013273580
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036156623 Issued in IL
Practice address
3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 62269-1282
Phone
(888) 828-8608
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 2019024514 MO
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 036156623 IL Primary

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 62269-1282

Mailing address

12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657
Phone (314) 806-1770

Other practice location 1

5301 Veterans Memorial Pkwy Ste 105
Saint Peters, MO 63376-3429
Phone (888) 828-8608

Other practice location 2

12855 N 40 Dr Ste 125
Saint Louis, MO 63141-8663
Phone (314) 806-1770

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE) Barnes Jewish St Peters Hospital Inc
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE) Progress West HealthCare Center
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE) Missouri Baptist Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190815000312 MO Practitioner - Neurosurgery 7012219454 Reassigns benefits to 2 organizations
I20210820002725 IL Practitioner - Neurosurgery 7012219454 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Missouri, Columbia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

112 Piper Hill Dr
Suite 12
Saint Peters, MO 63376-1690
Phone (636) 939-9202

12855 N 40 Dr
Suite 375
Saint Louis, MO 63141-8657

6812 State Route 162 200
Maryville, IL 62062-8562
Phone (618) 288-0900

6828 State Route 162
Suite a
Maryville, IL 62062-8558
Phone (618) 391-5380

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.16 of 100Reported as group
Quality
55.68
Promoting interoperability
100
Improvement activities
40
Cost
74.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion159
Laminectomy or laminotomy (partial removal of spine bones)61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC Multi-Specialty CurrentSince May 1, 2022 Accepting new patients
Urology of St. Louis, Inc. Multi-Specialty CurrentSince Aug 1, 2021 Accepting new patients
Urology of St. Louis, Inc. Multi-Specialty CurrentSince Aug 1, 2021 Accepting new patients
Urology of St. Louis, Inc. Single Specialty Past Accepting new patients

Locations

2044 Madison Ave
Ste G7
Granite City, IL 62040
Phone (314) 500-2424

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

6812 State Route 162
Ste 200
Maryville, IL 62062
Phone (618) 288-0900

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6828 State Route 162
Ste A
Maryville, IL 62062
Phone (618) 288-8363

3 Saint Elizabeth Blvd
Ste 3900
O Fallon, IL 62269
Phone (314) 806-1770

3 Saint Elizabeth Blvd
Ste 3200
O Fallon, IL 62269
Phone (618) 489-8030

12855 N 40 Dr
Saint Louis, MO 63141
Phone (314) 432-4415

12855 N 40 Dr
Ste 375
Saint Louis, MO 63141

3009 N Ballas Rd
Ste 250C
Saint Louis, MO 63131
Phone (314) 432-5616

12855 N 40 Dr
Ste 125
Saint Louis, MO 63141
Phone (314) 806-1770

112 Piper Hill Dr
Ste 12
Saint Peters, MO 63376
Phone (314) 806-1770

5301 Veterans Memorial Pkwy
Ste 105
Saint Peters, MO 63376
Phone (314) 806-1770

112 Piper Hill Dr
Ste 3
Saint Peters, MO 63376
Phone (314) 806-1770

965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054

3195 Phoenix Center Dr
Washington, MO 63090
Phone (636) 231-5623

Networks

  • IL HMO C-SNP
  • IL PPO Downstate
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

  • Direct secure messaging: stephenjohans@slus.allscriptsdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1013273580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-806-1770",
            "fax_number": "314-558-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 3900",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691282",
            "telephone_number": "888-828-8608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 Veterans Memorial Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633763429",
            "country_code": "US",
            "telephone_number": "888-828-8608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12855 N 40 Dr Ste 125",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418663",
            "country_code": "US",
            "telephone_number": "314-806-1770",
            "fax_number": "314-558-9017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANS",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2019024514",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036156623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "Y",
            "endpointDescription": "bjc",
            "affiliationName": "Barnes Jewish St Peters Hospital Inc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "112 Piper Hill Dr Ste 12",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633761690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "Y",
            "endpointDescription": "bjc",
            "affiliationName": "Progress West HealthCare Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "112 Piper Hill Dr Ste 12",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633761690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "Y",
            "endpointDescription": "bjc",
            "affiliationName": "Missouri Baptist Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5301 Veterans Memorial Pkwy Ste 105",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633763429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.