Advanced Bone & Joint – Orthopaedic Surgery Physician, NPI 1225182157
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Advanced Bone & Joint
112, Piper Hill Drive, Saint Peters, Saint Charles County, Missouri, 63376, United States
SUITE 9
SAINT PETERS, MO 633761690
Phone: (636) 441-3444
Fax: (636) 441-9832
Type: Location
430, 16, Narodnaya Street, Sosnovka, Народный округ, Saint Petersburg, Northwestern Federal District, 190000, Russia
SAINT PETERS, MO 633760008
Phone: (636) 441-3444
Fax: (636) 441-9832
Type: Mailing
5200 EXECUTIVE CENTRE PKWY STE 300
SAINT PETERS, MO 633763809
Phone: (636) 441-3444
Fax: (636) 441-9832
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-07-31 (679 days ago).
Enrollment records
2
Earliest due date
2024-07-31
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 |
|---|---|---|---|---|
| O20081231000306 | O | Clinic/Group Practice | MO | 2025-08-31 |
| O20100930071029 | O | Physician - Orthopedic/Orthopedic Surgery | MO | 2024-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 63376)
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