Individual provider Active NPI

Stephen Angelo Boveri, MD

  • Obstetrics & Gynecology Physician
  • Fenton, MO
National Provider Identifier
1386679660
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
112092 Issued in MO
Practice address
1011 Bowles Ave
Suite 215
Fenton, MO 63026-2395
Phone
(636) 680-1960
Fax
(636) 680-1964
NPI assigned
Jul 12, 2006
Last updated
Nov 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 112092 MO Primary

Addresses

Primary practice location

1011 Bowles Ave
Suite 215
Fenton, MO 63026-2395

Mailing address

1011 Bowles Ave
Suite 215
Fenton, MO 63026-2395
Phone (636) 680-1960

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
I20120416000457 MO Practitioner - Obstetrics/Gynecology 5991859076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County Obstetrics and Gynecology, IncGroup PAC ID 2769536929, 2 clinicians

Practice addresses (Care Compare)

1859 Bowles Ave
Suite 103
Fenton, MO 63026-1944
Phone (636) 680-1960

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112092MOMDObstetrics & Gynecology Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1386679660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE",
            "address_2": "SUITE 215",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262395",
            "telephone_number": "636-680-1960",
            "fax_number": "636-680-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE",
            "address_2": "SUITE 215",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262395",
            "telephone_number": "636-680-1960",
            "fax_number": "636-680-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVERI",
        "first_name": "STEPHEN",
        "middle_name": "ANGELO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "112092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.