Individual provider Active NPI

Jay L Faurot III, MD

  • Anesthesiology Physician
  • Columbia, MO
National Provider Identifier
1265599823
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
103138 Issued in MO
Practice address
404 Keene St
Columbia, MO 65201
Phone
(572) 445-7300
Fax
(573) 445-7301
NPI assigned
Jan 3, 2007
Last updated
Nov 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 103138 MO Primary
Anesthesiology Physician 207L00000X 26300 MO

Addresses

Primary practice location

404 Keene St
Columbia, MO 65201

Mailing address

PO Box 7536
Columbia, MO 65205
Phone (573) 445-7300

Other identifiers 2

IdentifierTypeStateIssuer
050042925OtherMORR MEDICARE
20610907MedicaidMO

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
I20050428000810 MO Practitioner - Anesthesiology 4082653050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of New Mexico School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Orthopaedic Group LLPGroup PAC ID 9335042811, 91 clinicians

Practice addresses (Care Compare)

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Promoting interoperability
86
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103138MOMDAnesthesiology Physician
26300MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Orthopaedic Group, LLP CurrentSince Jan 1, 2021 Accepting new patients
Columbia Orthopaedic Group, LLP CurrentSince Jan 1, 2021 Accepting new patients

Locations

1 S Keene St
Columbia, MO 65201
Phone (573) 443-2402

1 S Keene St
Ste 1
Columbia, MO 65201

1 S Keene St
Ste 100
Columbia, MO 65201
Phone (573) 499-6501

1410 Forum Katy Pkwy
Ste 102
Columbia, MO 65203
Phone (573) 397-6556

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1265599823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7536",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65205",
            "telephone_number": "573-445-7300",
            "fax_number": "573-445-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "572-445-7300",
            "fax_number": "573-445-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUROT",
        "first_name": "JAY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "103138",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "26300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050042925",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20610907",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.