Active NPI
Modupe Adedamola Aderibigbe, D.P.M.
- Podiatrist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 2011018632
- Practice address
- 401 Holly Hills Ave
Saint Louis, MO 63111-2410 - Phone
- (314) 353-5190
- Fax
- (314) 353-7631
- NPI assigned
- Jan 6, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 016005470 | IL | |
| Podiatrist | 213E00000X | 2011018632 | MO | Primary |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 5901002232 | MI | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 5901002232 | MI |
Addresses
Primary practice location
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Mailing address
3824 S Grand Blvd
Saint Louis, MO 63118-3412
Phone (314) 814-8180
Other practice location 1
3824 S Grand Blvd
Saint Louis, MO 63118-3412
Phone (314) 814-8180
Other practice location 2
4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone (314) 531-5444
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
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carestl Health
Practice addresses (Care Compare)
1121 N Orleans St
Chicago, IL 60610-2511
Phone (877) 674-1211
5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820
7047 Emma Ave
Jennings, MO 63136-1049
Phone (314) 653-8070
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 19 |
| Removal or shaving of skin growth | 17 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016005470 | IL | MD | Podiatrist |
| 2011018632 | MO | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carestl Health | Current | Accepting new patients | |
| Family Care Health Centers | Current | Accepting new patients | |
| Family Care Health Centers | Current | Accepting new patients | |
| Carestl Health | Current | Accepting new patients | |
| Carestl Health | Current | Accepting new patients |
Locations
3312 Ashby Rd
Saint Ann, MO 63074
Phone (314) 493-6200
1218 Shepley Dr
Saint Louis, MO 63137
Phone (314) 367-8520
3824 S Grand Blvd
Saint Louis, MO 63118
Phone (314) 481-1615
11300 Dunn Rd
Saint Louis, MO 63138
Phone (505) 999-9290
5541 Riverview Blvd
Saint Louis, MO 63120
Phone (314) 389-4566
4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336
401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190
5471 Martin Luther King Dr
Saint Louis, MO 63112
Phone 3143675820 ext. 2221
7047 Emma Ave
Saint Louis, MO 63136
Phone (314) 653-8070
4500 Pope Ave
Saint Louis, MO 63115
Phone 3143675820 ext. 84940
Interoperability endpoints
- modupe.aderibigbe@cstl.eclinicaldirectplus.com
Organizations & group practices 6
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.
-
dba Homer G. Phillips Health Center
- Federally Qualified Health Center (FQHC)
- Saint Louis, MO
- NPI 1376685529
-
- Podiatrist
- Middleburg, FL
- NPI 1568160091
-
- Federally Qualified Health Center (FQHC)
- Overland, MO
- NPI 1275363137
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1972596088
-
- Federally Qualified Health Center (FQHC)
- Saint Louis, MO
- NPI 1023285624
-
- Federally Qualified Health Center (FQHC)
- Saint Louis, MO
- NPI 1508867508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1407092927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3824 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631183412",
"telephone_number": "314-814-8180",
"fax_number": "314-814-8188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 HOLLY HILLS AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631112410",
"telephone_number": "314-353-5190",
"fax_number": "314-353-7631"
}
],
"practiceLocations": [
{
"address_1": "3824 S Grand Blvd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631183412",
"country_code": "US",
"telephone_number": "314-814-8180",
"fax_number": "314-814-8188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4352 Manchester Ave",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631102138",
"country_code": "US",
"telephone_number": "314-531-5444",
"fax_number": "314-531-0063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ADERIBIGBE",
"first_name": "MODUPE",
"middle_name": "ADEDAMOLA",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-06",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016005470",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MO",
"license": "2011018632",
"primary": true
},
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "MI",
"license": "5901002232",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "MI",
"license": "5901002232",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.