Individual provider Active NPI

Timothy P. Brotherton Jr., MD

  • Gastroenterology Physician
  • Chesterfield, MO
National Provider Identifier
1053930586
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2023010843 Issued in MO
Practice address
17298 N Outer 40 Rd Ste 200
Chesterfield, MO 63005-1456
Phone
(314) 529-4900
Fax
(314) 434-2679
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2023010843 MO Primary

Addresses

Primary practice location

17298 N Outer 40 Rd Ste 200
Chesterfield, MO 63005-1456

Mailing address

17298 N Outer 40 Rd Ste 200
Chesterfield, MO 63005-1456
Phone (314) 977-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240207004136 MO Practitioner - HospitalistPractitioner - Gastroenterology 5597181792 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Gastroenterology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Gateway Gastroenterology IncGroup PAC ID 2668448713, 25 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

17298 N Outer 40 Rd
Suite 200
Chesterfield, MO 63005-1456
Phone (314) 529-4900

Hospital & facility affiliations

  • SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023010843MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Gastroenterology CurrentSince Feb 1, 2024 Accepting new patients
Gateway Gastroenterology Inc CurrentSince May 1, 2026 Accepting new patients
SSM Health Care Group CurrentSince Feb 1, 2024 Accepting new patients
Sound Physicians of Illinois, LLC Hospitalist CurrentSince Feb 1, 2024 Accepting new patients

Locations

121 Saint Lukes Center Dr
Ste 406
Chesterfield, MO 63017
Phone (314) 432-5900

17298 North Outer 40 Rd
Ste 200
Chesterfield, MO 63005
Phone (314) 529-4900

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

1402 S Grand Blvd
#12
Saint Louis, MO 63104
Phone (314) 577-8763

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

621 S New Ballas Rd
Ste 228A
Saint Louis, MO 63141
Phone (314) 251-4966

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJFAD
  • Direct secure messaging: tbrotherton372144@direct-ehr-ssmhc.com

Organizations & group practices 4

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 3

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1053930586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17298 N OUTER 40 RD STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051456",
            "telephone_number": "314-977-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17298 N OUTER 40 RD STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051456",
            "telephone_number": "314-529-4900",
            "fax_number": "314-434-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERTON",
        "first_name": "TIMOTHY",
        "middle_name": "P.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2023010843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.