NPIMap

Individual provider Active NPI

Mauricio Jose Avila Guerra, M.D.

  • Neurological Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1487016390
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2023009168 Issued in MO
Practice address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 617-3420
Fax
(314) 617-3430
NPI assigned
Mar 22, 2016
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2023009168 MO Primary

Addresses

Primary practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1008 S Spring Ave RM 3100
Saint Louis, MO 63110-2520
Phone (146) 173-5463

Other practice location 1

1501 N Campbell Ave
Room 4303
Tucson, AZ 85724-5070
Phone (520) 626-0704

Other names 1

  • Dr. Mauricio J. Avila Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526001233 MO Practitioner - Neurosurgery 5193018059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion110
Laminectomy or laminotomy (partial removal of spine bones)20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023009168MOMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jun 1, 2023 Accepting new patients
SSM Health Care Group CurrentSince Jun 1, 2023 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
Banner University Medical Center Tucson Neurological Surgery Past Accepting new patients
SSM-Sluh Inc Past Accepting new patients

Locations

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-1320

Interoperability endpoints

  • Direct secure messaging: mavila454873@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1487016390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE RM 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "146-173-5463",
            "fax_number": "314-617-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-3420",
            "fax_number": "314-617-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_2": "Room 4303",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857245070",
            "country_code": "US",
            "telephone_number": "520-626-0704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVILA GUERRA",
        "first_name": "MAURICIO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2023009168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURICIO",
            "last_name": "AVILA",
            "middle_name": "J.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.