Organization Active NPI

Neil S Snyder DPM PC

  • Foot Surgery Podiatrist
  • Ellisville, MO
National Provider Identifier
1669679429
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
000660 Issued in MO
Legal business name
NEIL S SNYDER DPM PC
Practice address
16087 Manchester Rd
Ellisville, MO 63011-2103
Phone
(636) 230-3883
Fax
(636) 230-3884
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Dr. Neil S Snyder, DPMNPI 1306828199
Title
President
Phone
(636) 230-3883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 000660 MO Primary

Addresses

Primary practice location

16087 Manchester Rd
Ellisville, MO 63011-2103

Mailing address

16087 Manchester Rd
Ellisville, MO 63011-2103
Phone (636) 230-3883

Other identifiers 1

IdentifierTypeStateIssuer
501463806MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070529000078 MO Part B Supplier - Clinic/Group Practice 1355448333 Receives reassigned benefits from 2 practitioners
Practice locations: Florissant, MO; O Fallon, MO; Ellisville, MO
O20100930019691 MO DME Supplier - Physician - Podiatry 1355448333 Practice locations: Ellisville, MO

National Provider Directory

National Provider Directory

Locations

16087 Manchester Rd
Ellisville, MO 63011
Phone (636) 230-3883

1224 Graham Rd
Ste 1106
Florissant, MO 63031
Phone (314) 355-2230

300 Medical Plz
Ste 230
Lake St Louis, MO 63367
Phone (636) 625-1111

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1669679429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16087 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112103",
            "telephone_number": "636-230-3883",
            "fax_number": "636-230-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16087 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112103",
            "telephone_number": "636-230-3883",
            "fax_number": "636-230-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL S SNYDER DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-230-3883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MO",
            "license": "000660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501463806",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.