Brendan Manuel Fong, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

2013020671 Issued in MO

Practice address

12855 N 40 Dr Ste 125
Saint Louis, MO 63141-8663

Phone

(314) 806-1770

NPI assigned

Jul 1, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

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

Specialty

Neurosurgery

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians

Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
• Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score

74.76 of 100Reported as group

Quality

54.98

Promoting interoperability

85

Improvement activities

40

Cost

73.39

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Urology of St. Louis, Inc.

  • Specialist
  • Saint Louis, MO
  • NPI 1528017191

  IL

  Medicare reassignment Care Compare group NPD
• Anderson Medical Group, LLC

  • General Practice Physician
  • Maryville, IL
  • NPI 1700807716

  Neurological Surgery

  Medicare reassignment Care Compare group NPD
• Aging Well Health Care, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1215936588
  Care Compare group
• Urology of St. Louis, Inc.

  • Specialist
  • O Fallon, IL
  • NPI 1265392476
  NPD
• Urology of St. Louis, Inc.

  • Urology Physician
  • Fairview Heights, IL
  • NPI 1528901287
  NPD (past)

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

• Barnes Jewish St Peters Hospital Inc

  • General Acute Care Hospital
  • Saint Peters, MO
  • NPI 1144238908
  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302
  Care Compare affiliation

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1245670504",
    "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": "314-362-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 125",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418663",
            "telephone_number": "314-806-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 3900",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691282",
            "country_code": "US",
            "telephone_number": "314-806-1770",
            "fax_number": "314-558-9017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 Piper Hill Dr Ste 12",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761690",
            "country_code": "US",
            "telephone_number": "888-828-8608",
            "fax_number": "314-806-1770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "BRENDAN",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036158187",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2013020671",
            "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": "Missouri Baptist Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12855 N 40 Dr Ste 125",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418663",
            "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"
        }
    ],
    "other_names": []
}

• Thomas Folwarski
• Kimberly Fonda
• Harry Jerome Fondren, D.D.S.
• Lilah Taylor Fones, MD
• Wyatt Andrew Fones
• Jerry Fong, MD
• Thomas H. Fong, M.D.
• Wing Man Fong, PHD
• Carson Blaine Fonner, DPT
• Ricardo Alejandro Fonseca Ruiz, MD

• Neurological Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Neurological Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.