Individual provider Active NPI

Jon Brandon Carlson, M.D.

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1508178799
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2024037003 Issued in MO
Practice address
621 S New Ballas Rd Ste 3005B
Saint Louis, MO 63141-8266
Phone
(314) 251-7070
NPI assigned
Jul 5, 2010
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2024037003 MO Primary
Orthopaedic Trauma Physician 207XX0801X 48167 KY

Addresses

Primary practice location

621 S New Ballas Rd Ste 3005B
Saint Louis, MO 63141-8266

Mailing address

621 S New Ballas Rd Ste 3005B
Saint Louis, MO 63141-8266
Phone (314) 251-7070

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
I20241107000825 MO Practitioner - Orthopedic Surgery 1850686288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Indiana Medical College, School of Medicine of Purdue University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Trauma and General Surgery LLCGroup PAC ID 1658320700, 44 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 3005B
Saint Louis, MO 63141-8266
Phone (314) 251-7070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Melanoma (skin cancer) excision1-10
Removal of tissue12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Trauma and General Surgery, LLC Orthopaedic Surgery CurrentSince Oct 14, 2024 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

621 S New Ballas Rd
Ste 560A
Saint Louis, MO 63141
Phone (314) 251-6440

Organizations & group practices 2

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 4

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": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1508178799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 3005B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418266",
            "telephone_number": "314-251-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 3005B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418266",
            "telephone_number": "314-251-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JON",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-05",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2024037003",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "KY",
            "license": "48167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.