Eugenio G Herbosa, DMD MMSC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

15229 Issued in MO

Practice address

12818 Tesson Ferry Road
Suite 204
St Louis, MO 63128

Phone

(314) 842-0020

Fax

(314) 842-1590

NPI assigned

Oct 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater St Louis Oral and Maxillofacial Surgery PCGroup PAC ID 4981893823, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Greater St Louis Oral & Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Louis, MO
  • NPI 1518158989
  Medicare reassignment Care Compare group
• Allen Sclaroff DDS Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Louis, MO
  • NPI 1114190220
  NPD (past)
• South County Dental Imaging Center

  • Radiology Clinic/Center
  • Saint Louis, MO
  • NPI 1053647008
  NPD (past)

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

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063593838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD",
            "address_2": "SUITE 1010",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-721-1010",
            "fax_number": "314-721-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12818 TESSON FERRY ROAD",
            "address_2": "SUITE 204",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-842-0020",
            "fax_number": "314-842-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBOSA",
        "first_name": "EUGENIO",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "DMD MMSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MO",
            "license": "15229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Herberger, PH.D.
• Mark F Herbers, MD
• Julie F Herbert, LCSW
• Robyn Shea Herbert, PHD
• Christina Marie Herbosa, MD
• Jesse L Herche, MD, PH.D
• Stella Hercules
• Here for You Home Healthcare LLC
• Juliet Hereford, PT
• Susan Herena, ACNP

• Oral & Maxillofacial Surgery (D.M.D.) in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.