Stephen Angelo Boveri, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Fenton, MO
NPI 1386679660 · NPPES record last updated Nov 6, 2012
Key facts
- NPI
- 1386679660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 112092 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- 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, Inc
Practice addresses (Care Compare)
1859 Bowles Ave
Suite 103
Fenton, MO 63026-1944
Phone (636) 680-1960
Hospital & facility affiliations
- SSM St Clare Health Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120416000457 | MO | Practitioner - Obstetrics/Gynecology | 5991859076 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112092 | MO | MD | Obstetrics & Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 112092 | MO | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208651604 | Medicaid | MO |
Other providers in Fenton, MO
- Susan Elizabeth Bonk
- Nicole M Book
- Melanie Marie Boon
- Aaron Bornstein
- Lawrence Vincent Boveri
- Michelle E Braun
- Amanda Nicole Breedlove
- Brian K Kindel OD PC
- Jacob Daniel Briegleb
- Lindsey N Bright
All providers in Fenton, MO · Obstetrics & Gynecology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.