THOMAS OTTO (NPI# 1417979113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417979113 |
| Entity Type | Individual |
| Full Name | THOMAS OTTO |
| Credential | MD |
| Practice Address |
3635 Vista St Louis MO 63110 |
| Mailing Address |
3691 Rutger Ave Provider Enrollment St Louis MO 63110 |
| Practice Telephone | 3145778850 |
| Practice Fax Number | 3142685121 |
| Mailing Telephone | 3149774440 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2008-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | R9866 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508086562 | Thomas Otto | Counselor | 452 W Market St, Xenia, OH 45385-2815 | 2007-05-01 |
| Street Address |
3635 VISTA |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194829705 | Donald L Kaminski | Surgery | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-12 |
| 1598869109 | William F Sasser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-12 |
| 1003910225 | Eddy C Hsueh | Surgery | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-08 |
| 1629172846 | Carl Freeman | Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-09-08 |
| 1457455677 | Richard D. Bucholz | Neurological Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-09-08 |
| 1356445571 | Bruce A Kraemer | Surgery | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-08 |
| 1073617296 | Ralph J Graff | Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-09-08 |
| 1932202363 | Keith S Naunheim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3635 Vista, 3rd Floor Department of Surgery, St Louis, MO 63110 | 2006-09-07 |
| 1972614626 | Saleem I Abdulrauf | Neurological Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-08-31 |
| 1639288236 | Robert M Maloney | Urology | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831268663 | South St Louis Orthopedic Group Inc | Orthopaedic Surgery | 9815 Mackenzie Road, St Louis, MO 63123 | 2006-11-07 |
| 1053338640 | John Anthony Boudreau | Orthopaedic Surgery | 3635 Vista Avenue, 7th Floor Desloge Towers, St Louis, MO 63110 | 2006-07-17 |
| 1346276383 | Matthew David Collard | Orthopaedic Surgery | 2325 Dougherty Ferry Road, Suite 100, St Louis, MO 63122-3356 | 2006-06-23 |
| 1275602005 | Mitchell M Mirbaha | Orthopaedic Surgery | 9815 Mackenzie Road, St Louis, MO 63123 | 2006-11-07 |
| 1881707644 | St Louis Orthopedic Institute Inc | Orthopaedic Surgery | 12855 North Forty Drive, Suite 125, St Louis, MO 63141 | 2006-08-16 |
| 1871504472 | Thomas F Debartolo | Orthopaedic Surgery | 3635 Vista, St Louis, MO 63110 | 2006-08-10 |
| 1093726655 | Elizabeth Engel | Orthopaedic Surgery | 3635 Vista, St Louis, MO 63110 | 2006-08-10 |
| 1245253590 | Howard M Place | Orthopaedic Surgery | 3635 Vista, St Louis, MO 63110 | 2006-07-26 |
| 1326060021 | David E Karges | Orthopaedic Surgery | 3635 Vista, St Louis, MO 63110 | 2006-07-24 |
| 1598784795 | Anver A Tayob | Orthopaedic Surgery | 3635 Vista, St Louis, MO 63110 | 2006-07-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.