NANCY P BIERMAN BIRNER MD
NPI 1043214778
Pediatrics in Saint Louis, MO

Q: What is Nancy Birner's NPI number?

The NPI number for Nancy Birner is 1043214778. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Q: What is Nancy Birner's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Nancy Birner was last updated on March 14, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 10, 2005PECOS EnrolledAccepts Medicare Assignment

12700 SOUTHFORK RD, STE 215, SAINT LOUIS, MO 63128(314) 543-5244(314) 543-5248 Get Directions Write a Review

NPPES record last updated: March 14, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 14, 2017, Jun 24, 2016 (2 updates tracked since 2016).

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About Nancy P Bierman Birner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NANCY P BIERMAN BIRNER MD (NPI 1043214778) is an individual pediatrics provider in Saint Louis, Missouri, licensed in Missouri (2015029686) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1043214778

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameNANCY P BIERMAN BIRNERCredential: MD

Location Address12700 SOUTHFORK RD, STE 215Saint Louis, MO 63128-3201

Mailing Address12700 Southfork Rd, Ste 215Saint Louis, MO 63128-3201 · (314) 543-5244 · Fax (314) 543-5248

Phone(314) 543-5244

Fax(314) 543-5248

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateJune 10, 2005

Last NPPES UpdateMarch 14, 20172 updates tracked since enumeration

✔ NPI 1043214778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in MO · 2015029686✔ Licensed in IL · 036-100129

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedInternal MedicineTaxonomy 207R00000X · License 2015029686 (MO)

12700 SOUTHFORK RD, Saint Louis, MO 63128

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Other Identifiers 4

Medicare UPINH26177IL

Medicare PINK01499IL

Other156440098MO · Mo Ptan

Medicaid036100129IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nancy P Bierman Birner Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840196192

PECOS Enrollment IDI20031209000388

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

483 services267 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

181 services181 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

75 services51 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

66 services66 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

64 services64 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

45 services38 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

39 services26 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

26 services26 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

26 services26 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

20 services17 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

19 services19 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

17 services16 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

17 services15 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

14 services11 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

13 services13 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

13 services13 patients

Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report G0403

An Electrocardiogram (ECG) with 12 leads is a non-invasive test that measures the electrical activity of your heart. It's performed during your initial physical examination to screen for heart conditions. The results are interpreted and compiled into a report for further evaluation.

13 services13 patients

Blood glucose (sugar) level 82947

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

12 services12 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital

Acute Care Hospitals · Belleville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140185

Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County

Emergency services Birthing friendly

Red Bud Regional Hospital

Critical Access Hospitals · Red Bud, IL

OwnershipProprietary

CMS Certification Number141348

Location325 Spring StreetRed Bud, IL 62278 · Randolph County

Emergency services

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260020

Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County

Emergency services Birthing friendly

Mercy Hospital South

Acute Care Hospitals · Saint Louis, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260077

Location10010 Kennerly RoadSaint Louis, MO 63128 · St. Louis County

Emergency services

Missouri Baptist Medical Center

Acute Care Hospitals · Town And Country, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260108

Location3015 N Ballas RdTown And Country, MO 63131 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

100%80 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers45 claims103 services$5.87 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers14 claims15 services$1.06 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers15 claims15 services$179.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEERA SHARDA MD

Internal Medicine

12700 SOUTHFORK RD, STE 200/220
SAINT LOUIS, MO 63128

St. Louis County (314) 543-5942

MAUREEN E HUBER FNP

Nurse Practitioner (Family)

12700 SOUTHFORK RD, STE 280
SAINT LOUIS, MO 63128

St. Louis County (314) 525-4990

DR. IQBAL AMIN M.D.

Internal Medicine (Geriatric Medicine)

12700 SOUTHFORK RD, SUITE 105
SAINT LOUIS, MO 63128

St. Louis County (318) 525-1866

ST. ANTHONY'S PHYSICIAN ORGANIZATION

Internal Medicine

12700 SOUTHFORK RD, STE 290
SAINT LOUIS, MO 63128

St. Louis County (314) 525-4973

ST. ANTHONY'S PHYSICIAN ORGANIZATION

Internal Medicine

12700 SOUTHFORK RD, STE 270
SAINT LOUIS, MO 63128

St. Louis County (314) 525-4520

DR. SUSAN WILSON YANG MD

Internal Medicine

12700 SOUTHFORK RD, SUITE 200/220
SAINT LOUIS, MO 63128

St. Louis County (314) 543-5942

RICHARD XAVIER BRENNAN M.D.

Obstetrics & Gynecology

12700 SOUTHFORK RD, STE 230
SAINT LOUIS, MO 63128

St. Louis County (314) 849-3711

GENERAL SURGERY OF ST LOUIS PC

Surgery

12700 SOUTHFORK RD, SUITE 235
SAINT LOUIS, MO 63128

St. Louis County (314) 842-2226

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nancy Birner's NPI number?

The NPI number for Nancy Birner is 1043214778. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Where is Nancy Birner located?

Nancy Birner practices at 12700 Southfork Rd Ste 215, Saint Louis, MO 63128. The listed phone number is (314) 543-5244.

What is Nancy Birner's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Nancy Birner enrolled in Medicare?

Yes. Nancy Birner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nancy Birner accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 4 other insurers list Nancy Birner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nancy Birner affiliated with any hospitals?

According to CMS data, Nancy Birner is affiliated with Memorial Hospital, Red Bud Regional Hospital, Mercy Hospital St Louis, Mercy Hospital South and Missouri Baptist Medical Center.

When was this NPI record last updated?

The NPPES record for Nancy Birner was last updated on March 14, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.