Individual provider Active NPI

Neil S Snyder, DPM

  • Podiatrist
  • Ellisville, MO
National Provider Identifier
1306828199
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
9410M1971 Issued in MI
Practice address
16087 Manchester Rd
Ellisville, MO 63011-2103
Phone
(636) 230-3883
Fax
(636) 230-3884
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 9410M1971 MI Primary
Podiatrist 213E00000X 000660 MO

Addresses

Primary practice location

16087 Manchester Rd
Ellisville, MO 63011-2103

Mailing address

16087 Manchester Rd
Ellisville, MO 63011
Phone (636) 230-3883

Other identifiers 6

IdentifierTypeStateIssuer
4696830001OtherMODMERC
303056709MedicaidMO
480030905OtherMORRMC
990001778OtherGROUP NUMBER
501463806OtherGROUP NUMBER
CK2632OtherGROUP NUMBER

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070529000044 MO Practitioner - Podiatry 3274576863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neil S Snyder DPM PCGroup PAC ID 1355448333, 2 clinicians

Practice addresses (Care Compare)

16087 Manchester Rd
Ellisville, MO 63011-2103
Phone (636) 230-3883

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue66
Removal or shaving of skin growth32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000660MOMDClinical Social Worker
9410M1971MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Neil S Snyder DPM PC Podiatrist CurrentSince Mar 19, 2007 Accepting new patients

Locations

16087 Manchester Rd
Ellisville, MO 63011
Phone (636) 230-3883

1224 Graham Rd
Ste 1106
Florissant, MO 63031
Phone (314) 355-2230

5551 Winghaven Blvd
Ste 260
O Fallon, MO 63368
Phone (314) 205-6600

12410 Lusher Rd
Saint Louis, MO 63138
Phone (314) 741-3546

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1306828199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16087 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "63011",
            "telephone_number": "636-230-3883",
            "fax_number": "636-230-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16087 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112103",
            "telephone_number": "636-230-3883",
            "fax_number": "636-230-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "NEIL",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "9410M1971",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "000660",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4696830001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303056709",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "480030905",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "990001778",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "501463806",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "CK2632",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

Verify at the official NPI Registry.