NPIMap

Individual provider Active NPI

Sean Michael Rider, MD

  • Orthopaedic Surgery of the Spine Physician
  • Saint Louis, MO
National Provider Identifier
1790198646
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
2019011375 Issued in MO
Practice address
4921 Parkview PL
Ste 6a/6B/12a
Saint Louis, MO 63110-1032
Phone
(314) 747-2500
Fax
(314) 747-2598
NPI assigned
Jun 9, 2014
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2019011375 MO
Orthopaedic Surgery of the Spine Physician 207XS0117X 2019011375 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Ste 6a/6B/12a
Saint Louis, MO 63110-1032

Mailing address

660 S Euclid Ave
CB 8233
Saint Louis, MO 63110-1010
Phone (314) 747-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715002252 LA Practitioner - Orthopedic Surgery 4981821204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Louisiana State University School of Medicine in New Orleans, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic and Interventional Spinal Care of LouisianaGroup PAC ID 0244460293, 10 clinicians

Practice addresses (Care Compare)

76 Starbrush Cir
Covington, LA 70433-7208
Phone (985) 400-5778

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion283
Laminectomy or laminotomy (partial removal of spine bones)116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019011375MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic and Interventional Spinal Care of Louisiana Orthopaedic Surgery CurrentSince Sep 1, 2020 Accepting new patients
Fairway Medical Center, LLC Past Accepting new patients
Avala Physician Network, LLC Orthopaedic Surgery PastSince Sep 1, 2020 Accepting new patients

Locations

76 Starbrush Cir
Covington, LA 70433
Phone (985) 871-6800

15828 Professional Plz
Hammond, LA 70403
Phone (985) 674-1700

19184 Dr John Lambert Dr
Hammond, LA 70403
Phone (985) 542-7766

459 Corporate Dr
Houma, LA 70360
Phone (985) 400-5778

4441 N I 10 Service Rd W
Metairie, LA 70006
Phone (985) 400-5778

1570 Lindberg Dr
Ste 4
Slidell, LA 70458
Phone (985) 892-8934

Organizations & group practices 3

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1790198646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8233",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-2500",
            "fax_number": "314-747-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "STE 6A/6B/12A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-747-2500",
            "fax_number": "314-747-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2019011375",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "2019011375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.