NPIMap

Organization Active NPI

Orthopedic Associates, LLC

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1720159775
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC ASSOCIATES, LLC
Practice address
1050 Old Des Peres Rd
Suite 100
Saint Louis, MO 63131-1873
Phone
(314) 569-0612
Fax
(314) 966-0664
NPI assigned
Nov 13, 2006
Last updated
Jun 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Authorized official

Name
Mr. Paul E Roberts
Title
Executive Director
Phone
(314) 714-3211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1050 Old Des Peres Rd
Suite 100
Saint Louis, MO 63131-1873

Mailing address

1050 Old Des Peres Rd
Suite 100
Saint Louis, MO 63131-1873
Phone (314) 569-0612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040924000034 MO Part B Supplier - Clinic/Group Practice 7113995333 Receives reassigned benefits from 16 practitioners
Practice locations: Bonne Terre, MO; Fenton, MO; Saint Louis, MO
O20071107000266 IL Part B Supplier - Clinic/Group Practice 7113995333 Receives reassigned benefits from 6 practitioners
Practice locations: Columbia, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

55 Nesbit Dr
Ste B
Bonne Terre, MO 63628
Phone (636) 937-3337

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1720159775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 OLD DES PERES RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311873",
            "telephone_number": "314-569-0612",
            "fax_number": "314-966-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OLD DES PERES RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311873",
            "telephone_number": "314-569-0612",
            "fax_number": "314-966-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-714-3211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.