Unknown Individual – Geriatric Medicine (Internal Medicine) Physician, NPI 1558403519
Geriatric Medicine (Internal Medicine) Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
PO BOX 2580
SPRINGFIELD, MO 658012580
Phone: (417) 829-4620
Fax: (417) 829-4316
Type: Mailing
1965 S FREMONT AVE
SUITE 300
SPRINGFIELD, MO 658042201
Phone: (417) 820-3760
Fax: (417) 820-3770
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 228 | 76 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 34 | 33 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 33 | 33 | $0 |
| G0008 | Administration of influenza virus vaccine | 26 | 26 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 24 | 24 | $0 |
Insurance plans in this area (ZIP 65801)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | MO | 90670 | Pneumococcal vaccine for injection into muscle | 14 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| - | MO | |
| - | MO | |
| - | MO | |
| Clinical Psychologist | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| U R O L O G Y | MO | |
| P O D I A T R Y | MO | |
| - | KS |
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