NPIMap

Individual provider Active NPI

Patrick Reardon, M.D.

  • Orthopaedic Surgery Physician
  • O'Fallon, IL
National Provider Identifier
1275996183
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036179603 Issued in IL
Practice address
670 Pierce Blvd
O Fallon, IL 62269-2579
Phone
(618) 206-2070
Fax
(618) 206-2071
NPI assigned
Mar 30, 2016
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X 2022021266 MO
Orthopaedic Surgery Physician 207X00000X 036179603 IL Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 2022021266 MO

Addresses

Primary practice location

670 Pierce Blvd
O Fallon, IL 62269-2579

Mailing address

670 Pierce Blvd
O Fallon, IL 62269-2579
Phone (618) 206-2070

Other practice location 1

12639 Old Tesson Rd
Saint Louis, MO 63128-2711
Phone (314) 849-0311

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address preardon377435@ewd.direct.hshs.org Direct
Direct Messaging Address patrick.reardon@direct.signature.nextgenshare.com Health Information Exchange (HIE)

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
I20220705001468 MO Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 3375806037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Toledo College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians

Practice addresses (Care Compare)

12639 Old Tesson Rd
Suite 115
Saint Louis, MO 63128-2786
Phone 31484903112384

15425 Manchester Rd
Ballwin, MO 63011-3077
Phone (636) 220-6969

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.04 of 100Reported as individual
Quality
89.16
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)42
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Medical Group, Inc Orthopaedic Surgery CurrentSince Aug 1, 2022 Accepting new patients
Signature Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1011 Bowles Ave
Ste 100
Fenton, MO 63026

12639 Old Tesson Rd
Ste 115
Saint Louis, MO 63128
Phone (314) 842-8655

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, 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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1275996183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PIERCE BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692579",
            "telephone_number": "618-206-2070",
            "fax_number": "618-206-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PIERCE BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692579",
            "telephone_number": "618-206-2070",
            "fax_number": "618-206-2071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12639 Old Tesson Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282711",
            "country_code": "US",
            "telephone_number": "314-849-0311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REARDON",
        "first_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2022021266",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036179603",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2022021266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preardon377435@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "670 Pierce Blvd",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622692579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick.reardon@direct.signature.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "12639 Old Tesson Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631282711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.