Individual provider Active NPI

John Charles Philibert, MD

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1629572193
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2022016374 Issued in MO
Practice address
12634 Olive Blvd
Dept Anesthesiology
Saint Louis, MO 63141-6337
Phone
(800) 862-9980
Fax
(314) 362-1185
NPI assigned
Mar 20, 2018
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 2022016374 MO Primary

Addresses

Primary practice location

12634 Olive Blvd
Dept Anesthesiology
Saint Louis, MO 63141-6337

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 862-9980

Other identifiers 1

IdentifierTypeStateIssuer
200054943MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20220719000556 MO Practitioner - Anesthesiology 9133474133 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Southern Illinois University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Slu Hospital Anesthesia Physician Billing LLCGroup PAC ID 3274842331, 98 clinicians
Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians

Practice addresses (Care Compare)

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

1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 257-8000

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022016374MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Slu Hospital Anesthesia Physician Billing, LLC Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Washington University CurrentSince Jun 1, 2024 Accepting new patients
Missouri Baptist Medical Center Anesthesiology CurrentSince Aug 19, 2024 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
Washington University CurrentSince Jun 1, 2024 Accepting new patients

Locations

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

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

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

12634 Olive Blvd
Saint Louis, MO 63141
Phone (314) 434-0600

1402 S Grand Blvd
#M260
Saint Louis, MO 63104
Phone (314) 617-2919

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

Interoperability endpoints

  • Direct secure messaging: jphilibert255966@direct-ehr-ssmhc.com

Organizations & group practices 6

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 2

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1629572193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12634 OLIVE BLVD",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416337",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIBERT",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-04-17",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2022016374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200054943",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "12634 Olive Blvd",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.