Individual provider Active NPI

Donald A Degrange, MD

  • Orthopaedic Surgery of the Spine Physician
  • Saint Louis, MO
National Provider Identifier
1952364796
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
2009013842 Issued in MO
Practice address
621 S New Ballas Rd Ste 142a
Saint Louis, MO 63141-8254
Phone
(314) 251-3990
Fax
(314) 251-5390
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 2009013842 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 142a
Saint Louis, MO 63141-8254

Mailing address

777 S New Ballas Rd Ste 329E
Saint Louis, MO 63141-8720
Phone (314) 994-0313

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
I20091030000428 MO Practitioner - Orthopedic Surgery 3779470851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Virginia School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 142a
Saint Louis, MO 63141-8254
Phone (314) 251-3990

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7172SDMDPharmacist
2009013842MOMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Donald a. Degrange,MD,LLC Orthopaedic Surgery of the Spine CurrentSince Jul 29, 2009 Accepting new patients
Xcelerate Physical Therapy Inc. Past Accepting new patients
Conejo Pain Specialists Medical Group Inc Past Accepting new patients
Slssc, LLC PastSince Jul 26, 2011 Accepting new patients

Locations

621 S New Ballas Rd
Ste 142A
Saint Louis, MO 63141
Phone (314) 251-3990

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/879/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1952364796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD STE 329E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418720",
            "telephone_number": "314-994-0313",
            "fax_number": "314-994-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 142A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418254",
            "telephone_number": "314-251-3990",
            "fax_number": "314-251-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRANGE",
        "first_name": "DONALD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "2009013842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.