Neurosurgery of St Louis – Specialist, NPI 1528017191
Specialist
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Neurosurgery of St Louis
3009 N Ballas Rd Ste 250C
Saint Louis, MO 631312323
Phone: (314) 806-1770
Fax: (314) 558-9017
Type: Location
12855 N 40 Dr Ste 350
Saint Louis, MO 631418669
Phone: (314) 567-6071
Type: Location
112 Piper Hill Dr Ste 12
Saint Peters, MO 633761690
Phone: (636) 996-9202
Type: Location
PO BOX 14369
SAINT LOUIS, MO 631784369
Phone: (314) 567-6071
Fax: (314) 453-9965
Type: Mailing
12855 N 40 DR STE 375
SAINT LOUIS, MO 631418657
Phone: (314) 567-6071
Fax: (314) 453-9965
Type: Location
3 Saint Elizabeth Blvd Ste 3200
O Fallon, IL 622691281
Phone: (618) 489-8030
Type: Location
1035 Bellevue Ave Ste 211
Richmond Heights, MO 631171846
Phone: (314) 567-0671
Type: Location
1010 Old Des Peres Rd
Des Peres, MO 631311865
Phone: (314) 729-0077
Type: Location
12855 N 40 Dr Ste 125
Saint Louis, MO 631418663
Phone: (314) 806-1770
Type: Location
326 Fountains Pkwy
Fairview Heights, IL 622082041
Phone: (618) 277-3109
Type: Location
3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 622691282
Phone: (314) 806-1770
Type: Location
215 Dunn Rd
Florissant, MO 630317928
Phone: (314) 315-9917
Type: Location
3165 McKelvey Rd Ste 102
Bridgeton, MO 630442550
Phone: (314) 408-3244
Type: Location
111 Saint Lukes Center Dr Ste 40
Chesterfield, MO 630173509
Phone: (314) 434-3433
Type: Location
6812 State Route 162 Ste 200
Maryville, IL 620628562
Phone: (618) 288-0900
Type: Location
North Forty Drive, Westwood, Saint Louis County, Missouri, 63131, United States
SUITE 375
SAINT LOUIS, MO 631418635
Phone: (314) 567-6071
Fax: (314) 567-7961
Type: Mailing
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: 2022-07-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (801 days ago).
Enrollment records
3
Earliest due date
2024-03-31
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 |
|---|---|---|---|---|
| O20050502001141 | O | Clinic/Group Practice | IL | 2024-03-31 |
| O20050629000005 | O | Clinic/Group Practice | MO | 2024-07-31 |
| O20220706001645 | O | Physician - Urology | MO | 2025-10-31 |
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 63131)
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