OLD TESSON SURGERY CENTER
NPI 1104082692
Clinic/Center - Ambulatory Surgical in Saint Louis, MO

NPI Status: Active since August 04, 2008

Contact Information

12639 OLD TESSON RD
STE 130
SAINT LOUIS, MO
ZIP 63128
Phone: (314) 729-0785
Fax: (314) 667-3629

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 26D0985652
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 04-24-2027

About OLD TESSON SURGERY CENTER

This page provides the complete NPI Profile along with additional information for Old Tesson Surgery Center, a provider established in Saint Louis, Missouri operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1104082692 assigned on August 2008. The practitioner's primary taxonomy code is 261QA1903X with license number 129-4 (MO). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Old Tesson Surgery Center. The authorized official of this NPI record is Christopher Hartshorn (Officer/authorized Official)

NPI
1104082692
Provider Legal Name
OLD TESSON SURGERY CENTER, L.P.
Other Organization Name
OLD TESSON SURGERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
12639 OLD TESSON RD STE 130 SAINT LOUIS, MO 63128
Location Phone
(314) 729-0785
Location Fax
(314) 667-3629
Mailing Address
12639 OLD TESSON RD STE 130 SAINT LOUIS, MO 63128
Mailing Phone
(314) 729-0785
Mailing Fax
(314) 667-3629
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-04-2008
Last Update Date
10-14-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
129-4
License State
MO

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - EPO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - EPO
  • Focused Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Standard Silver + Vision + Adult Dental - PPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Catastrophic Pathway (+ Incentives) - EPO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic Standard - EPO
  • Gold Simple - EPO
  • Silver Classic Standard - EPO
  • Silver Elite Saver Plus - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple PCP Saver - EPO
  • Silver Simple Women's Health with Menopause Benefits - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO
  • UHC Silver Standard+ (Dental + Vision, No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CHRISTOPHER HARTSHORN

Authorized Official Title
OFFICER/AUTHORIZED OFFICIAL
Authorized Official Phone
(314) 800-2017

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Imaging guidance for procedure, 60 minutes or less

Imaging guidance is a procedure where real-time images are used to direct medical tools during a treatment. This technique helps to improve accuracy and safety. The procedure typically lasts 60 minutes or less.

This service was performed 12 times for 12 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 42 times for 35 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 37 times for 31 patients

Removal of knee cartilage using an endoscope

This procedure, known as arthroscopic knee surgery, involves using a small camera (endoscope) to view the inside of your knee. Small instruments are used to remove damaged cartilage. This can help alleviate pain and improve knee function.

This service was performed 17 times for 17 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 30 times for 29 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D0985652
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
April 25, 2025
Certificate Expiration Date
April 24, 2027
Laboratory Director
ROBERT MEDLER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Old Tesson Surgery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104082692, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
2
Doubled → 4
Pos 8
6
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 0 → 0 2 → 4 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 0 + 8 + 4 + 6 + 1 + 8 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1104082692.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Physician Assistant
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Physician Assistant
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Surgery
12639 OLD TESSON RD
SAINT LOUIS, MO 63128
Occupational Therapist
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
Physical Therapist
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
Registered Nurse
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Clinic/Center (Ambulatory Surgical)
12639 OLD TESSON RD, SUITE 130
SAINT LOUIS, MO 63128
Nurse Practitioner
12639 OLD TESSON RD
SAINT LOUIS, MO 63128
Physical Therapy Assistant
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
Physical Therapy Assistant
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
Physical Therapy Assistant
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
Surgery
12639 OLD TESSON RD
SAINT LOUIS, MO 63128
Durable Medical Equipment & Medical Supplies
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
Durable Medical Equipment & Medical Supplies
12639 OLD TESSON RD, 116
SAINT LOUIS, MO 63128
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE115
SAINT LOUIS, MO 63128
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104082692, enumerated as an "organization" on August 04, 2008.

The provider is located at 12639 OLD TESSON RD STE 130 SAINT LOUIS, MO 63128 and the phone number is (314) 729-0785.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.