NICHOLAS STAUB – Podiatrist, NPI 1790274066

NICHOLAS STAUB is a healthcare provider. based in Bridgeton, Missouri. specializing in PODIATRY. They hold a License No. 1091 (MN). The NPI Number for NICHOLAS STAUB is 1790274066

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS STAUB
NPI
1790274066
Phone
(314) 344-7545
Address
12303 DE PAUL DR
Enumeration Date
2 May 2018
Last Update Date
23 August 2021

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
6127888778
Graduation Year
2018 (8 years ago)
PAC ID
8921404690
Group Practice PAC ID
1254401300
Professional Enrollment ID
I20210903000541
Address ID
MN554232673RI6625XSXXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

285 PODIATRY in MO

Provider Addresses for NICHOLAS STAUB

  • 12303 DE PAUL DR

    BRIDGETON, MO 630442512

    Phone: (314) 344-7545

    Type: Location

  • 14102, Ridgemont Drive, Townhomes of Timber Hills, Urbandale, Polk County, Iowa, 50323, United States

    URBANDALE, IA 503232485

    Phone: (515) 360-9999

    Type: Mailing

  • 12303 De Paul Dr

    Bridgeton, MO 630442512

    Phone: (314) 344-7545

    Type: Location

  • 6625 LYNDALE AVE S STE 300

    RICHFIELD, MN 554232491

    Phone: (612) 788-8778

    Fax: (612) 869-3473

    Type: Mailing

  • 6625 LYNDALE AVE S STE 105

    RICHFIELD, MN 554232673

    Phone: (612) 200-8029

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $114.

Total Amount is formed as General ($114) + Research ($0) + Ownership ($0) = $114.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Stryker Corporation ($44).

Total Amount

$114

General + Research + Ownership

Payments

4

Total payment records

General Amount

$114

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-09-03

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210903000541IPodiatryMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
11721Removal of fingernails or toenails, 6 or more nails503219$0
11056Removal of noncancer thickened skin growth, 2-4 growths20695$0
99203New patient office or other outpatient visit, 30-44 minutes126126$0
11055Removal of noncancer thickened skin growth, 1 growth12566$0
99213Established patient office or other outpatient visit, 20-29 minutes7159$0
View full utilization report →

Insurance plans in this area (ZIP 63044)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254401300View full group profile
NameSpecialtyState
P O D I A T R YMD
P O D I A T R YMN
P O D I A T R YMN
P O D I A T R YPA
P O D I A T R YMN
-MN
P O D I A T R YMI

Reviews

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Frequently asked questions

Is NICHOLAS STAUB listed with a National Provider Identifier?
Yes — NICHOLAS STAUB has NPI 1790274066 on file in the registry.
Would NICHOLAS STAUB appear as active to a payer?
You can treat NICHOLAS STAUB as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is NICHOLAS STAUB?
NICHOLAS STAUB is associated with Podiatrist in the directory — Clinical services aligned with this taxonomy classification.
Is NICHOLAS STAUB associated with Bridgeton?
Public fields place NICHOLAS STAUB around Bridgeton, Missouri. Always confirm the exact site before visiting.
Can I trust this NPI listing for NICHOLAS STAUB?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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