Individual provider Active NPI

Ramin Matthew Lalezari, MD

  • Orthopaedic Hand Surgery Physician
  • Bridgeton, MO
National Provider Identifier
1285138883
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
2024033465 Issued in MO
Practice address
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone
(314) 344-6000
NPI assigned
Mar 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 2024033465 MO Primary

Addresses

Primary practice location

12303 De Paul Dr
Bridgeton, MO 63044-2512

Mailing address

416 Willow Weald Path
Chesterfield, MO 63005-1293
Phone (310) 592-7501

Other practice location 1

12349 DePaul Dr
Suite 100
Bridgeton, MO 63044
Phone (314) 291-7900

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
I20240905001850 MO Practitioner - Orthopedic Surgery 1951732452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Cincinnati College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

12349 De Paul Dr
Suite 100
Bridgeton, MO 63044-2512
Phone (314) 291-7900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024033465MOMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Aug 26, 2024 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 26, 2024 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

12349 De Paul Dr
Ste 100
Bridgeton, MO 63044
Phone (314) 291-3399

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Interoperability endpoints

  • Direct secure messaging: rlalezari518761@direct-ehr-ssmhc.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1285138883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 WILLOW WEALD PATH",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051293",
            "telephone_number": "310-592-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "314-344-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12349 DePaul Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "63044",
            "country_code": "US",
            "telephone_number": "314-291-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALEZARI",
        "first_name": "RAMIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-11-01",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MO",
            "license": "2024033465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.