Individual provider Active NPI

Raymond Abdo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
National Provider Identifier
1629076674
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2003016130 Issued in MO
Practice address
10004 Kennerly Rd Ste 259B
Saint Louis, MO 63128-2177
Phone
(314) 596-9670
Fax
(314) 722-3090
NPI assigned
Jul 13, 2005
Last updated
Dec 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2003016130 MO Primary

Addresses

Primary practice location

10004 Kennerly Rd Ste 259B
Saint Louis, MO 63128-2177

Mailing address

10004 Kennerly Rd Ste 259B
Saint Louis, MO 63128-2177
Phone (314) 596-9670

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050822000086 MO Practitioner - Podiatry 2264462142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10004 Kennerly Rd
Suite 259B
Saint Louis, MO 63128-2177
Phone (314) 596-9670

12152 Tesson Ferry Rd
Suite 1
Saint Louis, MO 63128-1726

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue154
Removal of skin lesions1-10
Removal of nail tissue215
Removal or shaving of skin growth58
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003016130MOMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Foot and Ankle LLC Foot & Ankle Surgery CurrentSince Jul 1, 2005 Accepting new patients

Locations

10004 Kennerly Rd
Ste 259B
Saint Louis, MO 63128
Phone (314) 596-9670

12152 Tesson Ferry Rd
Saint Louis, MO 63128
Phone (314) 849-5414

6651 Chippewa St
Ste 210
Saint Louis, MO 63109
Phone (314) 646-8474

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, 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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1629076674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 259B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282177",
            "telephone_number": "314-596-9670",
            "fax_number": "314-722-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 259B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282177",
            "telephone_number": "314-596-9670",
            "fax_number": "314-722-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDO",
        "first_name": "RAYMOND",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2003016130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.