DR. MICHAEL F BURNS M.D.
NPI 1225071129
Orthopaedic Surgery - Sports Medicine in Saint Louis, MO
Quality Rating: 77.93 out of 100 score
NPI Status: Active since June 14, 2006
Contact Information
675 OLD BALLAS RD STE 100
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 733-9009
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Overall Quality Performance
- Quality Reporting
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 47
- Orthopaedic Surgery
- Sports Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MICHAEL BURNS
This page provides the complete NPI Profile along with additional information for Michael Burns, a provider established in Saint Louis, Missouri with a medical specialization in Orthopaedic Surgery, focusing in sports medicine and more than 47 years of experience. He graduated from Saint Louis University School Of Medicine in 1979. The healthcare provider is registered in the NPI registry with number 1225071129 assigned on June 2006. The practitioner's primary taxonomy code is 207XX0005X with license number R6E77 (MO). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1225071129
- Provider Name
- DR. MICHAEL F BURNS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141
- Location Phone
- (314) 733-9009
- Mailing Address
- 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141
- Mailing Phone
- (314) 733-9009
- Medical School Name
- SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1979
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-14-2006
- Last Update Date
- 10-29-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery Sports Medicine
- Taxonomy Code
- 207XX0005X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R6E77
- License State
- MO
- Taxonomy Description
- An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | R6E77 (MO) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care - EPO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
- Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
- Bronze S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200044115 | OTHER (01) | MO | RAILROAD MEDICARE |
| 0900104 | OTHER (01) | MO | UNITED HEALTH CARE |
| 179488 | OTHER (01) | MO | HEALTHLINK |
| 3140893002 | OTHER (01) | MO | CIGNA |
| 202176210 | MEDICAID (05) | MO | |
| 4457981 | OTHER (01) | MO | AETNA |
| 21525 | OTHER (01) | MO | BLUE CROSS BLUE SHIELD |
| 83368V3223 | OTHER (01) | MO | GROUP HEALTH PLAN |
Medicare Participation & PECOS Enrollment Status
Michael Burns is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Burns is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4880678739
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20040617000171
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Continuous passive motion exercise device for use on knee only (HCPCS:E0935)
1 DME suppliers used 14 Medicare Claims 271 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection, methylprednisolone acetate, 40 mg
Knee replacement
Lower limb (leg) arthroscopy (minimally invasive joint repair)
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Replacement of knee joint, both sides of knee
X-ray of hip, 2-3 views
X-ray of knee, 3 views
X-ray of knee, 4 or more views
X-ray of lower and sacral spine, 2-3 views
X-ray of pelvis, 1-2 views
X-ray of shoulder, minimum of 2 views
X-ray of upper spine, 2-3 views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 45 times for 30 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 137 times for 106 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 67 times for 52 patientsMethylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
This service was performed 42 times for 24 patientsA knee replacement is a surgical procedure where a damaged or diseased knee joint is replaced with an artificial one. This can relieve pain and improve mobility. The procedure involves removing damaged parts of the knee and inserting a prosthetic joint. Recovery may take several weeks.
This service was performed for 18 patientsLower limb arthroscopy is a minimally invasive procedure that allows doctors to examine and repair issues in your leg joints. It involves making small incisions through which a tiny camera and instruments are inserted. This technique can help diagnose and treat various joint problems with less pain and quicker recovery time.
This service was performed for 14 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 38 times for 38 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 36 times for 36 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 15 times for 14 patientsAn X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
This service was performed 14 times for 14 patientsAn X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
This service was performed 34 times for 34 patientsAn X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
This service was performed 64 times for 62 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
This service was performed 22 times for 22 patientsAn X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.
This service was performed 11 times for 11 patientsAn X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
This service was performed 33 times for 29 patientsAn X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.
This service was performed 13 times for 13 patientsOverall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 77.93, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 77.93 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 84.98
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 41.46
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 41.46
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Closing the Referral Loop: Receipt of Specialist Report | 45% | 20 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Documentation of Current Medications in the Medical Record | 94% | 2758 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Enhancements/regular updates to practice websites/tools that also include considerations for patients with cognitive disabilities | Yes | N/A |
| Enhancements and ongoing regular updates and use of websites/tools that include consideration for compliance with section 508 of the Rehabilitation Act of 1973 or for improved design for patients with cognitive disabilities. Refer to the CMS website on Section 508 of the Rehabilitation Act https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/Section508/index.html?redirect=/InfoTechGenInfo/07_Section508.asp that requires that institutions receiving federal funds solicit, procure, maintain and use all electronic and information technology (EIT) so that equal or alternate/comparable access is given to members of the public with and without disabilities. For example, this includes designing a patient portal or website that is compliant with section 508 of the Rehabilitation Act of 1973 | ||
| e-Prescribing | 87% | 1727 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 66% | 525 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Health Information Exchange | 93% | 41 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Medication Reconciliation | 94% | 761 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 96% | 1704 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 51% | 525 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 35% | 1463 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 92% | 1007 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 76% | 1704 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Secure Messaging | 17% | 1704 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of High-Risk Medications in the Elderly | 3% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 525 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michael Burns is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MERCY HOSPITAL ST LOUIS | 615 NEW BALLAS ROAD SAINT LOUIS, MO 63141 | (314) 251-6000 | Acute Care Hospitals | |
| MISSOURI BAPTIST MEDICAL CENTER | 3015 N BALLAS RD TOWN AND COUNTRY, MO 63131 | (314) 996-5000 | Acute Care Hospitals | |
| BARNES-JEWISH WEST COUNTY HOSPITAL | 12634 OLIVE BOULEVARD CREVE COEUR, MO 63141 | (314) 996-8000 | Acute Care Hospitals | |
| ST LUKES HOSPITAL | 232 S WOODS MILL RD CHESTERFIELD, MO 63017 | (314) 434-1500 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 2 | 5 | 0 | 7 | 1 | 1 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 4 | 5 | 0 | 7 | 2 | 1 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 4 + 5 + 0 + 7 + 2 + 1 + 4 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1225071129 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 10 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1104454057 | SUSAN EILEEN FESSLER APRN, FNP-BC Individual | Nurse Practitioner (Family) | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1356692669 | MRS. JENNIFER LYNN LEDBETTER FNP Individual | Nurse Practitioner (Family) | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1518968759 | RICHARD JOHNSTON M.D. Individual | Orthopaedic Surgery | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1942224258 | DR. GLEN E JOHNSON M.D. Individual | Orthopaedic Surgery | 675 OLD BALLAS RD STE 100 CREVE COEUR, MO 63141 (314) 733-9009 |
| 1033145875 | DR. JESSE G SUSI M.D. Individual | Orthopaedic Surgery | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1316974439 | DR. DAVID W STREGE M.D. Individual | Orthopaedic Surgery (Hand Surgery) | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1497782106 | MR. RICKY A POWELL PA-C Individual | Physician Assistant | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1912935750 | DR. JOHN E TESSIER M.D. Individual | Orthopaedic Surgery | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1598127615 | DR. MITCHELL WATTLES MD Individual | Orthopaedic Surgery | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
| 1316471394 | DOUGLAS MATIJAKOVICH M.D. Individual | Orthopaedic Surgery | 675 OLD BALLAS RD STE 100 SAINT LOUIS, MO 63141 (314) 733-9009 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1225071129, enumerated in the NPI registry as an "individual" on June 14, 2006
The provider is located at 675 Old Ballas Rd Ste 100 Saint Louis, Mo 63141 and the phone number is (314) 733-9009
The provider's speciality is Orthopaedic Surgery with taxonomy code 207XX0005X with a focus in Sports Medicine
The provider has more than 47 years of experience. He graduated from Saint Louis University School Of Medicine in 1979.
The provider might be accepting Accepts: Aetna CVS Health, Railroad Medicare, Medicare,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Injection, methylprednisolone acetate, 40 mg, Knee replacement, Lower limb (leg) arthroscopy (minimally invasive joint repair), New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes, Replacement of knee joint, both sides of knee, X-ray of hip, 2-3 views, X-ray of knee, 3 views, X-ray of knee, 4 or more views, X-ray of lower and sacral spine, 2-3 views, X-ray of pelvis, 1-2 views, X-ray of shoulder, minimum of 2 views and X-ray of upper spine, 2-3 views.
The practitioner is affiliated to the following hospital(s): MERCY HOSPITAL ST LOUIS, MISSOURI BAPTIST MEDICAL CENTER, BARNES-JEWISH WEST COUNTY HOSPITAL and ST LUKES HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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