Individual provider Active NPI

Jonathan Mathew George, DPM

  • Foot & Ankle Surgery Podiatrist
  • Saint Charles, MO
National Provider Identifier
1700311503
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2020016128 Issued in MO
Practice address
1475 Kisker Rd Ste 260
Saint Charles, MO 63304-8788
Phone
(860) 818-1039
Fax
(636) 928-4497
NPI assigned
Apr 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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 2020016128 MO Primary

Addresses

Primary practice location

1475 Kisker Rd Ste 260
Saint Charles, MO 63304-8788

Mailing address

5104 Fountainview Cir
Saint Charles, MO 63303-3387
Phone (860) 818-1039

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
I20200805001266 MO Practitioner - Podiatry 4284051178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven Frank, DPM, LLCGroup PAC ID 1759443302, 4 clinicians

Practice addresses (Care Compare)

1475 Kisker Rd
Suite 260
Saint Peters, MO 63304-8788
Phone (636) 928-4447

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions162
Removal of nail tissue688
Removal or shaving of skin growth448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020016128MOMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Frank DPM LLC Foot & Ankle Surgery CurrentSince Aug 1, 2020 Accepting new patients

Locations

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

300 Medical Plz
Ste 122
Lake St Louis, MO 63367
Phone (636) 928-4447

12855 N 40 Dr
Ste 175
Saint Louis, MO 63141
Phone (314) 434-9600

1475 Kisker Rd
Ste 260
Saint Peters, MO 63304
Phone (636) 928-4447

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 1

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": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1700311503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 FOUNTAINVIEW CIR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033387",
            "telephone_number": "860-818-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD STE 260",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048788",
            "telephone_number": "860-818-1039",
            "fax_number": "636-928-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "JONATHAN",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-29",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2020016128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.