DES PERES SQUARE SURGERY CENTER – NPI #1497720882
Clinic/Center

DES PERES SQUARE SURGERY CENTER is an AHC clinic located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1497720882 to DES PERES SQUARE SURGERY CENTER on February 21, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “DES PERES SQUARE SURGERY CENTER” is a dba name, the actual legal business name for this organization is THE ST LOUIS MO ORTHOPAEDIC ASC LLC. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 3 years ago on Sep 07, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DES PERES SQUARE SURGERY CENTER below.

NPI Profile for
THE ST LOUIS MO ORTHOPAEDIC ASC LLC

NPI Number
1497720882
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
THE ST LOUIS MO ORTHOPAEDIC ASC LLC
Doing Business As (dba): DES PERES SQUARE SURGERY CENTER
Primary location
1050 OLD DES PERES RD
SUITE 150
SAINT LOUIS, MO 63131-1873
Phone: (314) 569-2918 Fax: (314) 569-9473
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PHILLIP CLENDENIN
PRESIDENT
Phone: (615) 665-1283
Updated
Identifiers

Identifiers for DES PERES SQUARE SURGERY CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
other260042667MOTRICARE
otherBLUE CROSS BLUE SHIELDMO149879
otherRAILROAD MEDICAREMO490005580
otherUS DEPT OF LABORMO611789400
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 MO 171-1

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.