Individual provider Active NPI

Lindsay Marie Tolksdorf, D.O.

  • Family Medicine Physician
  • O Fallon, IL
National Provider Identifier
1992155741
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2018021677 Issued in MO
Practice address
3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269
Phone
(618) 233-7880
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125069133 IL
Family Medicine Physician 207Q00000X 2018021677 MO Primary

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269

Mailing address

180 S 3Rd St
Suite 300
Belleville, IL 62220-1952
Phone (618) 233-5480

Other practice location 1

180 S 3rd St
Suite 300
Belleville, IL 62220-1952
Phone (618) 233-5480

Other names 1

  • Lindsay Marie Brewster Former name

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
I20240423002328 MO Practitioner - Emergency Medicine 9830471549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

121 Saint Lukes Ctr Dr
Chesterfield, MO 63017

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125069133ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of St. Luke'S, LLC Family Medicine CurrentSince Mar 18, 2024 Accepting new patients
Physician Specialists of St Lukes LLC Family Medicine Past Accepting new patients

Locations

121 Saint Lukes Center Dr
Chesterfield, MO 63017
Phone (314) 434-3278

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1992155741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S 3RD ST",
            "address_2": "SUITE 300",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201952",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-233-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 S 3rd St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622201952",
            "country_code": "US",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLKSDORF",
        "first_name": "LINDSAY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125069133",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018021677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "BREWSTER",
            "middle_name": "MARIE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.