MR. JASTIN L ANTISDEL MD
NPI 1073714564
Otolaryngology in Saint Louis, MO

Q: What is Jastin Antisdel's NPI number?

The NPI number for Jastin Antisdel is 1073714564. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Q: What is Jastin Antisdel's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Jastin Antisdel was last updated on January 13, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 30, 2007PECOS EnrolledAccepts Medicare Assignment

1225 S GRAND BLVD, GARDEN LEVEL, SAINT LOUIS, MO 63104(314) 977-5110(314) 977-7686 Get Directions Write a Review

NPPES record last updated: January 13, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Jastin L Antisdel Md NPPES

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

MR. JASTIN L ANTISDEL MD (NPI 1073714564) is an individual otolaryngology provider in Saint Louis, Missouri, licensed in Missouri (2005036993) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Ssm Health Saint Louis University Hospital, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1073714564

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameMR. JASTIN L ANTISDELCredential: MD

Location Address1225 S GRAND BLVD, GARDEN LEVELSaint Louis, MO 63104-1016

Mailing Address1008 S Spring Ave Fl 3Saint Louis, MO 63110-2520 · (314) 977-8884 · Fax (314) 977-1820

Phone(314) 977-5110

Fax(314) 977-7686

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2004

Enumeration DateMay 30, 2007

Last NPPES UpdateJanuary 13, 2021

NPPES CertifiedJanuary 13, 2021

✔ NPI 1073714564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

Licenses✔ Licensed in MO · 2005036993✔ Licensed in GA · 062018

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

1225 S GRAND BLVD, Saint Louis, MO 63104

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Secondary Practice Location 1

Location 1555 N New Ballas Rd Ste 260Saint Louis, MO 63141-6886 · Phone (314) 977-6362 · Fax (314) 977-7686

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Oscar Insurance Company.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

Mr. Jastin L Antisdel 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 ID4486709490

PECOS Enrollment IDI20100702000378

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 9

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.

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

68 services45 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.

65 services39 patients

Diagnostic exam of nasal passages using an endoscope 31231

36 services22 patients

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

32 services20 patients

Biopsy or removal of nasal polyp or tissue using an endoscope 31237

A nasal biopsy or polyp removal is a procedure where an endoscope, a thin tube with a light and camera, is inserted into the nose. This allows the doctor to see and remove abnormal tissues or polyps, which are small growths. This procedure helps diagnose or treat nasal issues.

30 services21 patients

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.

17 services14 patients

Hospital Affiliations CMS Care Compare

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

Ssm Health Saint Louis University Hospital

Acute Care Hospitals · Saint Louis, MO

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260105

Location3635 Vista AveSaint Louis, MO 63110 · St. Louis City County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63104 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

$128.28 typical visit price

range $55.65 – $169.38

Typical copayment $32.07 (range $13.91 – $42.34)

Most-billed visit code 99204

Established Patient

$69.50 typical visit price

range $17.76 – $137.92

Typical copayment $17.37 (range $4.44 – $34.48)

Most-billed visit code 99213

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

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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.

DR. MATTHEW RUSSELL SMEDS MD

Surgery (Vascular Surgery)