Alyssa D Fajardo (NPI# 1659698058, PAC ID# 5395975171) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is COLORECTAL SURGERY (PROCTOLOGY).
| Nation Provider ID (NPI) | 1659698058 |
| PAC ID by PECOS | 5395975171 |
| Professional Enrollment ID | I20180808000752 |
| Full Name | Alyssa D Fajardo |
| Organization Legal Name | MISSOURI BAPTIST PHYSICIAN SERVICES LLC |
| Address |
555 N New Ballas Rd 265 Suburban Surgical St Louis MO 63141-6886 |
| Phone Number | 3149914644 |
| Gender | F |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2005 |
| Primary Specialty | COLORECTAL SURGERY (PROCTOLOGY) |
| Secondary Specialties | GENERAL SURGERY |
| Group Practice PAC ID | 0446294342 |
| Number of Group Practice Members | 28 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260108 | MISSOURI BAPTIST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 555 N New Ballas Rd, 265 Suburban Surgical, St Louis, MO 63141-6886 | 3149914644 | MISSOURI BAPTIST PHYSICIAN SERVICES LLC |
| Organization Legal Name | MISSOURI BAPTIST PHYSICIAN SERVICES LLC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nancy Jean Nickerson | Certified Clinical Nurse Specialist (cns) | Missouri Baptist Physician Services LLC | 3015 N Ballas Rd, Physician Services, St Louis, MO 63131-2329 |
| Michele C Woodley | Gastroenterology | Missouri Baptist Physician Services LLC | 3009 N Ballas Rd, Suite 359c, Saint Louis, MO 63131-2324 |
| Michael Mauney | Thoracic Surgery | Missouri Baptist Physician Services LLC | 3023 N Ballas Rd, Suite 150d, Saint Louis, MO 63131-2319 |
| Todd K Howard | Surgical Oncology | Missouri Baptist Physician Services LLC | 3015 N Ballas Rd, Physician Services, St Louis, MO 63131-2329 |
| Ann M Bayne | Nurse Practitioner | Missouri Baptist Physician Services LLC | 3023 N Ballas Rd, Suite 150d, Saint Louis, MO 63131-2319 |
| Eric D Lederman | Colorectal Surgery (proctology) | Missouri Baptist Physician Services LLC | 3015 N Ballas Rd, Physician Services, St Louis, MO 63131-2329 |
| Alaa A Elbendary | Gynecological Oncology | Missouri Baptist Physician Services LLC | 3015 N Ballas Rd, Physician Services, St Louis, MO 63131-2329 |
| Mary K Burch | Nurse Practitioner | Missouri Baptist Physician Services LLC | 555 N New Ballas Rd, 265 Suburban Surgical, St Louis, MO 63141-6886 |
| Jack R Oak | Vascular Surgery | Missouri Baptist Physician Services LLC | 3015 N Ballas Rd, Physician Services, St Louis, MO 63131-2329 |
| Jeane L Stohldrier | Physician Assistant | Missouri Baptist Physician Services LLC | 555 N New Ballas Rd, 265 Suburban Surgical, St Louis, MO 63141-6886 |
| Street Address |
555 N NEW BALLAS RD 265 SUBURBAN SURGICAL |
| City | ST LOUIS |
| State | MO |
| Zip | 63141-6886 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew M Wayne | Physical Medicine and Rehabilitation | Agility Orthopaedics, LLC | 555 N New Ballas Rd, Suite 175, Saint Louis, MO 63141-6825 |
| Amanda Maria Kearney | Nurse Practitioner | Empower Psych Centers LLC | 555 N New Ballas Rd, Suite 220, Creve Coeur, MO 63141-6844 |
| Mary K Burch | Nurse Practitioner | Missouri Baptist Physician Services LLC | 555 N New Ballas Rd, 265 Suburban Surgical, St Louis, MO 63141-6886 |
| Jeane L Stohldrier | Physician Assistant | Missouri Baptist Physician Services LLC | 555 N New Ballas Rd, 265 Suburban Surgical, St Louis, MO 63141-6886 |
| Jennifer N Sieb | Physician Assistant | Agility Orthopaedics, LLC | 555 N New Ballas Rd, Suite 175, Saint Louis, MO 63141-6825 |
| Jason D Rabenold | Orthopedic Surgery | Agility Orthopaedics, LLC | 555 N New Ballas Rd, Suite 175, Saint Louis, MO 63141-6825 |
| Sarah E Fehringer | Physician Assistant | Agility Orthopaedics, LLC | 555 N New Ballas Rd, Suite 175, Saint Louis, MO 63141-6825 |
| Daniel R Jasper | Internal Medicine | 555 N New Ballas Rd, Suite 250, Saint Louis, MO 63141-6849 | |
| Anthony J Margherita | Physical Medicine and Rehabilitation | West County Spine and Sports Medicine | 555 N New Ballas Rd, Suite 210, St Louis, MO 63141-6825 |
| Amy J Gable | Physician Assistant | Missouri Baptist Physician Services LLC | 555 N New Ballas Rd, 265 Suburban Surgical, St Louis, MO 63141-6886 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Finnerty | Nurse Practitioner | Associated Physicians Group Ltd | 845 N New Ballas Court, Suite 120, Creve Couer, MO 63141 |
| Enos Moss | Nurse Practitioner | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Matthew Stewart Wilson | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Erica Chick | Clinical Social Worker | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Thomas Horn | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Tianyuan Yin Cornell | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Patricia L Tracy | Physical Therapy | Associated Physicians Group, Ltd | 845 N New Ballas Court, Creve Couer, MO 63141 |
| Kevin O Easley | Gynecological Oncology | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Kelly L Ball | Nurse Practitioner | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Amy Kelly Neu | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Find all physicians in zip 63141 | |||
| City | ST LOUIS |
| Zip Code | 63141 |
| Specialty | COLORECTAL SURGERY (PROCTOLOGY) |
| City + Specialty | ST LOUIS + COLORECTAL SURGERY (PROCTOLOGY) |
Please comment or provide details below to improve the information on Alyssa D Fajardo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.