Individual provider Active NPI

Michael Harold Ralph, M.D.

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1730297862
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
R4C91 Issued in MO
Practice address
3535 S Jefferson Ave
Suite 201
Saint Louis, MO 63118-3930
Phone
(314) 669-7070
Fax
(314) 577-5726
NPI assigned
Aug 28, 2006
Last updated
Nov 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R4C91 MO Primary

Addresses

Primary practice location

3535 S Jefferson Ave
Suite 201
Saint Louis, MO 63118-3930

Mailing address

PO Box 66980
Saint Louis, MO 63166-6980
Phone (314) 669-7070

Other identifiers 1

IdentifierTypeStateIssuer
201725439MedicaidMO

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
I20090113000664 MO Practitioner - Orthopedic Surgery 5092816199 Practice locations: Saint Louis, MO

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Lee DC PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1730297862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66980",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631666980",
            "telephone_number": "314-669-7070",
            "fax_number": "314-577-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE",
            "address_2": "SUITE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183930",
            "telephone_number": "314-669-7070",
            "fax_number": "314-577-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALPH",
        "first_name": "MICHAEL",
        "middle_name": "HAROLD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "R4C91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201725439",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.