Individual provider Active NPI

Adam Shomstein, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MO
National Provider Identifier
1962793760
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
2016035827 Issued in MO
Practice address
520 Center St
Fenton, MO 63026-4141
Phone
(314) 516-3289
NPI assigned
Apr 27, 2011
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 2016035827 MO Primary

Addresses

Primary practice location

520 Center St
Fenton, MO 63026-4141

Mailing address

520 Center St
Fenton, MO 63026-4141
Phone (314) 516-3289

Other practice location 1

1365 Nykiel Ct
Ballwin, MO 63011-4246
Phone (314) 516-3289

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
I20161207000507 MO Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 6406136589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Kansas City University of Physicians and Surgeons, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Spine and Joint Pain Specialists LLCGroup PAC ID 2860772944, 2 clinicians

Practice addresses (Care Compare)

520 Ctr St
Fenton, MO 63026-4141
Phone (314) 516-3289

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Spine and Joint Pain Specialists LLC Pain Medicine CurrentSince Nov 15, 2016 Accepting new patients
St Louis Joint and Back Pain Specialists LLC Pain Medicine Current Accepting new patients

Locations

520 Center St
Fenton, MO 63026
Phone (314) 516-3289

Organizations & group practices 2

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1962793760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CENTER ST",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630264141",
            "telephone_number": "314-516-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 CENTER ST",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630264141",
            "telephone_number": "314-516-3289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Nykiel Ct",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630114246",
            "country_code": "US",
            "telephone_number": "314-516-3289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOMSTEIN",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MO",
            "license": "2016035827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.