Individual provider Active NPI

Ryan K Noirfalise, MPT

  • Orthopedic Physical Therapist
  • Chesterfield, MO
National Provider Identifier
1992730584
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2004002569 Issued in MO
Practice address
17363 Edison Ave
Chesterfield, MO 63005-1250
Phone
(636) 346-1371
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2004002569 MO Primary

Addresses

Primary practice location

17363 Edison Ave
Chesterfield, MO 63005-1250

Mailing address

17363 Edison Ave
Chesterfield, MO 63005-1250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060925000227 MO Practitioner - Physical Therapist in Private Practice 4284639303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Missouri Physical Therapy LLCGroup PAC ID 6901870187, 59 clinicians

Practice addresses (Care Compare)

15884 Manchester Rd
Ellisville, MO 63011-2208
Phone (636) 220-9335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004002569MOMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Physical Therapy LLC Orthopedic CurrentSince Jun 1, 2015 Accepting new patients

Locations

17363 Edison Ave
Chesterfield, MO 63005
Phone (314) 200-5032

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

15884 Manchester Rd
Ellisville, MO 63011
Phone (636) 220-9335

425 N New Ballas Rd
Ste 202
Saint Louis, MO 63141
Phone (314) 991-2562

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1992730584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17363 EDISON AVE",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17363 EDISON AVE",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051250",
            "telephone_number": "636-346-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOIRFALISE",
        "first_name": "RYAN",
        "middle_name": "K",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2004002569",
            "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 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.