NPIMap

Individual provider Active NPI

Frederick P Walters, M.D.

  • Urology Physician
  • Saint Louis, MO
National Provider Identifier
1114952074
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
R1J55 Issued in MO
Practice address
12345 W Bend Dr
Suite200
Saint Louis, MO 63128-2104
Phone
(314) 843-8000
Fax
(314) 843-3004
NPI assigned
Jul 11, 2006
Last updated
Feb 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X R1J55 MO Primary

Addresses

Primary practice location

12345 W Bend Dr
Suite200
Saint Louis, MO 63128-2104

Mailing address

12345 W Bend Dr
Suite200
Saint Louis, MO 63128-2104
Phone (314) 843-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000122 MO Practitioner - Urology 8022196989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Saint Louis University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South County Urological, IncGroup PAC ID 0042213001, 3 clinicians
St. Lukes Urology, LLCGroup PAC ID 0749602712, 11 clinicians

Practice addresses (Care Compare)

12345 W Bend Dr
Suite 200
Saint Louis, MO 63128-2253
Phone (314) 843-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South County Urological, Inc. Urology CurrentSince Jan 1, 1993 Accepting new patients
St. Lukes Urology, LLC Urology CurrentSince Nov 1, 2025 Accepting new patients
Modern Urology, Inc. Past Accepting new patients

Locations

226 S Woods Mill Rd
Ste 5
Chesterfield, MO 63017
Phone (636) 685-7830

226 S Woods Mill Rd
Ste 52W
Chesterfield, MO 63017
Phone (314) 434-2399

12345 W Bend Dr
Ste 200
Saint Louis, MO 63128
Phone (314) 843-8000

Interoperability endpoints

  • Direct secure messaging: frederickwalters@scu.medalliesdirect.net
  • FHIR API: https://app.meldrx.com/api/fhir/uc05427_southcountyurological

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1114952074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12345 W BEND DR",
            "address_2": "SUITE200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282104",
            "telephone_number": "314-843-8000",
            "fax_number": "314-843-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 W BEND DR",
            "address_2": "SUITE200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282104",
            "telephone_number": "314-843-8000",
            "fax_number": "314-843-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "FREDERICK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "R1J55",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.