SALLY J ELLEBRACHT-GERKE M.D.
NPI 1235168097
Family Medicine in Boonville, MO

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since July 02, 2006Opted out of Medicare · through Oct 1, 2026

17110 HIGHWAY 87, BOONVILLE, MO 65233(660) 672-7005(660) 882-3147 Get Directions Write a Review

NPPES record last updated: April 18, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Sally J Ellebracht-gerke M.d. NPPES

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

SALLY J ELLEBRACHT-GERKE M.D. (NPI 1235168097) is an individual family medicine provider in Boonville, Missouri, licensed in Missouri (2001014617) and active in the NPI registry since July 2006. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1235168097

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSALLY J ELLEBRACHT-GERKECredential: M.D.

Location Address17110 HIGHWAY 87Boonville, MO 65233-2939

Mailing Address17110 Highway 87Boonville, MO 65233-2939 · (660) 672-7005 · Fax (660) 882-3147

Phone(660) 672-7005

Fax(660) 882-3147

Sole ProprietorYes

Enumeration DateJuly 2, 2006

Last NPPES UpdateApril 18, 2013

✔ NPI 1235168097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 2001014617

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

17110 HIGHWAY 87, Boonville, MO 65233

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Other Identifiers 3

Medicare UPINH92205

Medicare ID-Type UnspecifiedH72C592MO

Medicaid209200401MO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Sally J Ellebracht-gerke M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2012 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2012

Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65233 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Full face mask used with positive airway pressure device, each A7030