Individual provider Active NPI

Steven Tedd Fogel, MD

  • Anesthesiology Physician
  • Columbia, MO
National Provider Identifier
1558313148
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R8071 Issued in MO
Practice address
1 Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 882-2569
Fax
(573) 882-2226
NPI assigned
May 16, 2006
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R8071 MO Primary

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65212-0001

Mailing address

4904 Thornbrook RDG
Columbia, MO 65203-9750
Phone (157) 335-5142

Other practice location 1

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 257-8000

Other identifiers 2

IdentifierTypeStateIssuer
201302338MedicaidMO
629589513AMedicaidGA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sfogel340631@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8071MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince May 24, 2007 Accepting new patients
Midwest Anesthesia Providers S.C Anesthesiology CurrentSince Sep 4, 2021 Accepting new patients
Curators of the University of Missouri CurrentSince May 24, 2007 Accepting new patients
Amsol Physicians of Columbus Ga LLC Anesthesiology Past Accepting new patients
Amsol Physicians of Columbus Ga Anesthesiology Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

101 S Fairview Rd
Columbia, MO 65203
Phone (573) 882-1095

404 N Keene St
Columbia, MO 65201
Phone (573) 875-9000

110 N Hospital Dr
Fulton, MO 65251
Phone (573) 642-5911

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1558313148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 THORNBROOK RDG",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039750",
            "telephone_number": "157-335-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-2569",
            "fax_number": "573-882-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-257-8000",
            "fax_number": "314-977-1617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "STEVEN",
        "middle_name": "TEDD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "R8071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201302338",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "629589513A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfogel340631@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sfogel340631@direct-ehr-ssmhc.com",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.