NPIMap

Organization Active NPI

The Orthopedic Center of St Louis LLC

  • Orthopaedic Surgery Physician
  • Chesterfield, MO
National Provider Identifier
1881808483
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
THE ORTHOPEDIC CENTER OF ST LOUIS LLC
Practice address
14825 N Outer 40 Rd Ste 200
Chesterfield, MO 63017-2152
Phone
(314) 336-2555
Fax
(314) 336-2557
NPI assigned
May 10, 2007
Last updated
Sep 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Dr. Mitchell B Rotman, M.D.NPI 1477555662
Title
Owner
Phone
(314) 336-2555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

14825 N Outer 40 Rd Ste 200
Chesterfield, MO 63017-2152

Mailing address

14825 N Outer Forty Ste 200
Chesterfield, MO 63017-2152
Phone (314) 336-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050718000075 MO Part B Supplier - Clinic/Group Practice 2668408022 Receives reassigned benefits from 14 practitioners
Practice locations: Chesterfield, MO

National Provider Directory

National Provider Directory
Tax ID family
The Orthopedic Center of St Louis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1881808483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14825 N OUTER FORTY STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172152",
            "telephone_number": "314-336-2555",
            "fax_number": "314-336-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 N OUTER 40 RD STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172152",
            "telephone_number": "314-336-2555",
            "fax_number": "314-336-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ORTHOPEDIC CENTER OF ST LOUIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "ROTMAN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-336-2555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.