Individual provider Active NPI

Fred Roanld Monterubio Jr., M.D.

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
National Provider Identifier
1962400143
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R9A68 Issued in MO
Practice address
3009 N Ballas Rd
Ste 356C
Saint Louis, MO 63131-2322
Phone
(314) 432-2880
Fax
(314) 432-4810
NPI assigned
Jul 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R9A68 MO Primary

Addresses

Primary practice location

3009 N Ballas Rd
Ste 356C
Saint Louis, MO 63131-2322

Mailing address

3009 N Ballas Rd
Ste 356C
Saint Louis, MO 63131-2322
Phone (314) 432-2880

Other identifiers 8

IdentifierTypeStateIssuer
0700217OtherUNITED HEALTH CARE
46318OtherGROUP HEALTH PLAN
4217036OtherAETNA
07-00217OtherMEDICARE COMPLETE
101340OtherHEALTHLINK
112759OtherBLUE CROSS BLUE SHIELD
SP15678OtherCIGNA
5143OtherHEALTHCARE USA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R9A68MOMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: fmonterubio244442@direct.carenet.org

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962400143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "STE 356C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-432-2880",
            "fax_number": "314-432-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "STE 356C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-432-2880",
            "fax_number": "314-432-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTERUBIO",
        "first_name": "FRED",
        "middle_name": "ROANLD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "R9A68",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0700217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "46318",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4217036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE COMPLETE",
            "identifier": "07-00217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "101340",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "112759",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "SP15678",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "5143",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.