Individual provider Active NPI

Edward Augustine Stapleton, M.D.

  • General Practice Physician
  • Saint Louis, MO
National Provider Identifier
1508279142
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1508279142 Issued in MO
Practice address
5000 Manchester Ave
Saint Louis, MO 63110-2012
Phone
(314) 747-5800
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 1508279142 MO Primary

Addresses

Primary practice location

5000 Manchester Ave
Saint Louis, MO 63110-2012

Mailing address

5000 Manchester Ave
Saint Louis, MO 63110-2012
Phone (314) 747-5800

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
I20220124001054 MO Practitioner - Preventive Medicine 4880991033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

463 Lynn Haven LN
Hazelwood, MO 63042-1808
Phone (314) 731-0448

83 Progress Pkwy
Maryland Heights, MO 63043-3701
Phone (314) 434-8174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1508279142MOMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Kansas PA Current Accepting new patients

Locations

6401 E Front St
Kansas City, MO 64120
Phone (816) 241-0603

83 Progress Pkwy
Maryland Hts, MO 63043
Phone (314) 434-8174

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1508279142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 MANCHESTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102012",
            "telephone_number": "314-747-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 MANCHESTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102012",
            "telephone_number": "314-747-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "EDWARD",
        "middle_name": "AUGUSTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "1508279142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.