Active NPI
Harry John Visser, DPM
- Foot & Ankle Surgery Podiatrist
- Creve Coeur, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 000431
- Practice address
- 11709 Old Ballas Rd
Suite 201
Creve Coeur, MO 63141-7029 - Phone
- (314) 432-1903
- Fax
- (314) 432-5105
- NPI assigned
- Jul 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 000431 | MO | Primary |
Addresses
Primary practice location
11709 Old Ballas Rd
Suite 201
Creve Coeur, MO 63141-7029
Mailing address
PO Box 419074
Creve Coeur, MO 63141-9074
Phone (314) 432-1903
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 301529822 | Medicaid | MO | |
| 301529806 | Medicaid | MO |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Kent State University College of Podiatric Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11709 Old Ballas Rd
Suite 201
Creve Coeur, MO 63141-7029
Phone (314) 432-1903
9594 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 274-6314
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.29 of 100
- Promoting interoperability
- 79
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000431 | MO | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Next Step Foot & Ankle Centers, Inc | Foot & Ankle Surgery | Current | Accepting new patients |
| Next Step Foot and Ankle Centers, Inc | Foot & Ankle Surgery | Current | Accepting new patients |
| SSM Depaul Medical Group, Inc. | Past | Accepting new patients | |
| Center for Advanced Foot & Ankle Surgery Inc | Foot & Ankle Surgery | Past | Accepting new patients |
Locations
500 W Pine St
Farmington, MO 63640
Phone (573) 701-9249
11709 Old Ballas Rd
Ste 201
Saint Louis, MO 63141
Phone (314) 432-1903
5139 Mattis Rd
Ste 102
Saint Louis, MO 63128
Phone (314) 396-9517
Interoperability endpoints
- hvisser@usfas.emadirect.md
- hvisser10482@direct-ehr-ssmhc.com
Organizations & group practices 5
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.
-
- Podiatrist
- Saint Louis, MO
- NPI 1518938919
Foot & Ankle Surgery
-
- Rehabilitation Clinic/Center
- Arnold, MO
- NPI 1639400179
-
- Foot & Ankle Surgery Podiatrist
- Saint Louis, MO
- NPI 1174595409
-
- Family Medicine Physician
- Florissant, MO
- NPI 1952312951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1285648576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 419074",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631419074",
"telephone_number": "314-432-1903",
"fax_number": "314-432-5105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11709 OLD BALLAS RD",
"address_2": "SUITE 201",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417029",
"telephone_number": "314-432-1903",
"fax_number": "314-432-5105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISSER",
"first_name": "HARRY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "MO",
"license": "000431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "301529822",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "301529806",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.