DR. MAXWELL SANFILIPPO-BURCHMAN MD
NPI 1124516125
Pediatrics - Pediatric Pulmonology in Saint Louis, MO
NPI Status: Active since April 25, 2018
Contact Information
1 CHILDRENS PL
SAINT LOUIS, MO
ZIP 63110
Phone: (314) 454-2694
Fax: (314) 454-2515
- Individual
- Male
- Years of Experience 8
- Pediatrics
- Pediatric Pulmonology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MAXWELL SANFILIPPO-BURCHMAN
This page provides the complete NPI Profile along with additional information for Maxwell Sanfilippo-burchman, a pediatrician established in Saint Louis, Missouri with a medical specialization in Pediatrics, focusing in pediatric pulmonology and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1124516125 assigned on April 2018. The practitioner's primary taxonomy code is 2080P0214X with license number 2021025616 (MO). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1124516125
- Provider Name
- DR. MAXWELL SANFILIPPO-BURCHMAN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1 CHILDRENS PL SAINT LOUIS, MO 63110
- Location Phone
- (314) 454-2694
- Location Fax
- (314) 454-2515
- Mailing Address
- 1 CHILDRENS PL SAINT LOUIS, MO 63110
- Mailing Phone
- (314) 454-2694
- Mailing Fax
- (314) 454-2515
- Medical School Name
- OTHER
- Graduation Year
- 2018
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-25-2018
- Last Update Date
- 05-13-2024
- Code Navigator
A pediatrician like Maxwell Sanfilippo-burchman is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
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
Pediatrics Pediatric Pulmonology
- Taxonomy Code
- 2080P0214X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 2021025616
- License State
- MO
- Taxonomy Description
- A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 2021017954 (MO) |
| 2 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 2021025616 (MO) |
| 3 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 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
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Maxwell Sanfilippo-burchman is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Maxwell Sanfilippo-burchman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7113263955
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240521003432
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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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 1124516125, we treat the final digit (5) 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 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 45 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
SAINT LOUIS, MO 63110
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124516125, enumerated as an "individual" on April 25, 2018.
The provider is located at 1 CHILDRENS PL SAINT LOUIS, MO 63110 and the phone number is (314) 454-2694.
Pediatrics with taxonomy code 2080P0214X and a focus in Pediatric Pulmonology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield and Oscar. Please consult your insurance carrier or call the provider to verify.
