Individual provider Active NPI

Daniel Joseph Thouvenot, DPM

  • Foot & Ankle Surgery Podiatrist
  • O'Fallon, IL
National Provider Identifier
1881031730
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016.005683 Issued in IL
Practice address
784 Wall St Ste C
O Fallon, IL 62269-2088
Phone
(618) 236-7444
Fax
(618) 726-2662
NPI assigned
Jun 2, 2013
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016.005683 IL Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 2013033616 MO

Addresses

Primary practice location

784 Wall St Ste C
O Fallon, IL 62269-2088

Mailing address

5139 Mattis Rd Ste 102
Saint Louis, MO 63128-2250
Phone (314) 909-1920

Other practice location 1

5383 State Route 154
Pinckneyville, IL 62274-3342
Phone (618) 236-7444

Other practice location 2

325 Spring St
Red Bud, IL 62278-1105
Phone (618) 236-7444

Other practice location 3

509 Hamacher St Ste 202
Waterloo, IL 62298-1592
Phone (618) 236-7444

Other practice location 4

3445 Bridgeland Dr
Bridgeton, MO 63044-2604
Phone (314) 739-7100

Other practice location 5

3505 College Ave Ste B
Alton, IL 62002-5065
Phone (618) 462-9695

Other practice location 6

3445 Bridgeland Dr
Bridgeton, MO 63044-2604
Phone (314) 739-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150804003106 MO Practitioner - Podiatry 9234443359 Reassigns benefits to 1 organization
I20150908003058 IL Practitioner - Podiatry 9234443359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12152 Tesson Ferry Rd
Saint Louis, MO 63128-1779
Phone (314) 849-7600

3505 College Ave B
Alton, IL 62002-5065
Phone (618) 462-9695

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Promoting interoperability
79
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue94
Removal of skin lesions11
Removal of nail tissue581
Removal or shaving of skin growth266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.005683ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Next Step Foot & Ankle Centers, Inc Foot & Ankle Surgery CurrentSince Aug 1, 2015 Accepting new patients
Next Step Foot and Ankle Centers, Inc Foot & Ankle Surgery CurrentSince Aug 1, 2015 Accepting new patients
Foot Specialists of Kansas City, PA PastSince Dec 7, 2022 Accepting new patients

Locations

3505 College Ave
Ste B
Alton, IL 62002
Phone (618) 462-9695

784 Wall St
Ste C
O Fallon, IL 62269
Phone (618) 236-7444

5383 State Route 154
Pinckneyville, IL 62274
Phone (618) 357-2131

509 Hamacher St
Ste 202
Waterloo, IL 62298
Phone (314) 997-1777

3445 Bridgeland Dr
Bridgeton, MO 63044
Phone (314) 739-7100

5139 Mattis Rd
Ste 102
Saint Louis, MO 63128
Phone (314) 396-9517

Interoperability endpoints

  • Direct secure messaging: dan.thouvenot@nsfaaci-il.direct.office.nextgen.com
  • Direct secure messaging: dthouvenot@usfas.emadirect.md

Organizations & group practices 10

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 2

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": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1881031730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 MATTIS RD STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282250",
            "telephone_number": "314-909-1920",
            "fax_number": "314-909-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 WALL ST STE C",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692088",
            "telephone_number": "618-236-7444",
            "fax_number": "618-726-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5383 State Route 154",
            "address_purpose": "LOCATION",
            "city": "Pinckneyville",
            "state": "IL",
            "postal_code": "622743342",
            "country_code": "US",
            "telephone_number": "618-236-7444",
            "fax_number": "618-726-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Spring St",
            "address_purpose": "LOCATION",
            "city": "Red Bud",
            "state": "IL",
            "postal_code": "622781105",
            "country_code": "US",
            "telephone_number": "618-236-7444",
            "fax_number": "618-726-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 Hamacher St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IL",
            "postal_code": "622981592",
            "country_code": "US",
            "telephone_number": "618-236-7444",
            "fax_number": "618-726-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3445 Bridgeland Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442604",
            "country_code": "US",
            "telephone_number": "314-739-7100",
            "fax_number": "314-739-3199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3505 College Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620025065",
            "country_code": "US",
            "telephone_number": "618-462-9695",
            "fax_number": "618-462-9651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3445 Bridgeland Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442604",
            "country_code": "US",
            "telephone_number": "314-739-7100",
            "fax_number": "314-739-3199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOUVENOT",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-02",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005683",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2013033616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.