GRANT RALSTON (MD) – Sports Medicine (Family Medicine) Physician, NPI 1568091189
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
144 SPORTS MEDICINE in MO
Provider Addresses for GRANT RALSTON (MD)
PO BOX 505673
SAINT LOUIS, MO 631505673
Phone:
Type: Mailing
3555 S NATIONAL AVE
SPRINGFIELD, MO 658077310
Phone: (000) 000-0000
Type: Location
201 W. Van Asche Drive
Fayetteville, AR 72703
Phone: (479) 521-0263
Type: Location
1423 N JEFFERSON AVE # B100
SPRINGFIELD, MO 658021917
Phone: (417) 269-8817
Fax: (417) 269-8744
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $44.
Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: VERTEX PHARMACEUTICALS INCORPORATED ($44).
Total Amount
$44
General + Research + Ownership
Payments
2
Total payment records
General Amount
$44
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| VERTEX PHARMACEUTICALS INCORPORATED | $44 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-07-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240725003463 | I | Sports Medicine | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63150)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Physical Medicine And Rehabilitation | MO | |
| Clinical Psychologist | MO | |
| Nurse Practitioner | MO | |
| Clinical Psychologist | MO | |
| Physician Assistant | MO | |
| Physician Assistant | MO | |
| - | MD | |
| H E M A T O L O G Y/ O N C O L O G Y | IL | |
| Nurse Practitioner | MO |
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