ANDRES LERNER MD
NPI 1285865204
Orthopaedic Surgery - Hand Surgery in O Fallon, IL

Active since August 07, 2009PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
670 PIERCE BLVD, O FALLON, IL 62269(618) 206-2094 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 6, 2022, Jan 25, 2016 (2 updates tracked since 2016).

About Andres Lerner Md NPPES

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

ANDRES LERNER MD (NPI 1285865204) is an individual hand surgery provider in O Fallon, Illinois, licensed in Texas (N4550) and active in the NPI registry since August 2009. He is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1285865204
Entity TypeIndividualMale
Primary Taxonomy207XS0106X
Provider Legal NameANDRES LERNERCredential: MD
Location Address670 PIERCE BLVDO Fallon, IL 62269-2579
Mailing Address670 Pierce BlvdO Fallon, IL 62269-2579 · (618) 206-2094
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateAugust 7, 2009
Last NPPES UpdateJanuary 6, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2022
NPI 1285865204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
Licenses Licensed in TX · N4550 Licensed in CA · A104207
Definition
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
670 PIERCE BLVD, O Fallon, IL 62269

Accepted 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

Andres Lerner 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 ID7416099379
PECOS Enrollment IDI20190426000845
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 14

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.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
276 services50 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.
178 services120 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
115 services115 patients
X-ray of wrist, minimum of 3 views 73110
An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
111 services25 patients
X-ray of hand, minimum of 3 views 73130
An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.
55 services19 patients
Release of wrist ligament using an endoscope 29848
This procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.
54 services50 patients

Hospital Affiliations CMS Care Compare 2

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

St Josephs Hospital

Acute Care Hospitals · Breese, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140145
Location9515 Holy Cross LnBreese, IL 62230 · Clinton County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62269 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
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.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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.

Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type L3809
DME-Orthotic Devices · category DF000N
1 supplier19 claims19 services$148.56 avg. paid by Medicare
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908
DME-Orthotic Devices · category DF000N
1 supplier29 claims29 services$53.71 avg. paid by Medicare
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf L3924
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$72.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

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

Nurse Practitioner (Family)
670 PIERCE BLVD
O FALLON, IL 62269
Physician Assistant
670 PIERCE BLVD
O FALLON, IL 62269
Family Medicine (Sports Medicine)
670 PIERCE BLVD
O FALLON, IL 62269
Nurse Practitioner
670 PIERCE BLVD
O FALLON, IL 62269
Nurse Practitioner (Family)
670 PIERCE BLVD
O FALLON, IL 62269
Physician Assistant
670 PIERCE BLVD
O FALLON, IL 62269
Family Medicine (Sports Medicine)
670 PIERCE BLVD
O FALLON, IL 62269
Physician Assistant
670 PIERCE BLVD
O FALLON, IL 62269

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 Andres Lerner's NPI number?

The NPI number for Andres Lerner is 1285865204. It was assigned to this individual provider in the NPPES registry on August 7, 2009.

Where is Andres Lerner located?

Andres Lerner practices at 670 Pierce Blvd, O Fallon, IL 62269. The listed phone number is (618) 206-2094.

What is Andres Lerner's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is Andres Lerner enrolled in Medicare?

Yes. Andres Lerner 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 Andres Lerner accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and UnitedHealthcare list Andres Lerner 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 Andres Lerner affiliated with any hospitals?

According to CMS data, Andres Lerner is affiliated with St Josephs Hospital and Hshs St Elizabeth's Hospital.

When was this NPI record last updated?

The NPPES record for Andres Lerner was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.