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KETAN SHARMA MD
NPI 1376982686
Plastic Surgery in Saint Louis, MO

Active since June 19, 2013PECOS EnrolledAccepts Medicare Assignment
83.32/100
CMS Quality Rating
1201 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 257-8000 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ketan Sharma Md NPPES

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

KETAN SHARMA MD (NPI 1376982686) is an individual plastic surgery provider in Saint Louis, Missouri, licensed in Missouri (2013018519) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Duke University School Of Medicine (2013).

NPPES Registry Identity

NPI1376982686
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameKETAN SHARMACredential: MD
Location Address1201 S GRAND BLVDSaint Louis, MO 63104-1016
Mailing Address1201 S Grand BlvdSaint Louis, MO 63104-1016
Phone(314) 257-8000
Sole ProprietorNo
Medical School CMSDuke University School Of MedicineGraduated 2013
Enumeration DateJune 19, 2013
Last NPPES UpdateMarch 17, 2021
NPPES CertifiedMarch 17, 2021
✔ NPI 1376982686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in MO · 2013018519
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
1201 S GRAND BLVD, Saint Louis, MO 63104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.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

Ketan Sharma 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 ID6507095700
PECOS Enrollment IDI20210726002727
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 5

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.

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.
63 services42 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.
30 services30 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.
23 services19 patients
Injection into tendon or ligament 20550
An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
18 services16 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
18 services18 patients

Hospital Affiliations CMS Care Compare 3

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130006
Location190 East Bannock StreetBoise, ID 83712 · Ada County
Emergency services Birthing friendly

St Luke's Nampa Medical Center

Acute Care Hospitals · Nampa, ID
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130071
Location9850 West St Lukes DriveNampa, ID 83687 · Canyon County
Emergency services Birthing friendly

St Luke's Mccall

Critical Access Hospitals · Mccall, ID
OwnershipProprietary
CMS Certification Number131312
Location1000 State StreetMccall, ID 83638 · Valley County
Emergency services Birthing friendly

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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
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.

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.

83.32/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.51
Promoting Interoperability100
Improvement Activities40
Cost64.88

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.

DOUG LONGO APRN
Nurse Practitioner (Acute Care)
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
JOHN JOSEPH HOUSER
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
NABIHA NOOR SHAMSHUDDIN MD
Hospitalist
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
AMAN PATEL
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
MS. KEELEY FERRELL RYAN PA-C
Physician Assistant
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-1320
PATRICK SWEENEY
Student in an Organized Health Care Education/Training Program
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
DR. SHAMEELA NASRULLAH KHIMANI MD
Pediatrics
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-3239
IBRAHIM SHAMASNEH M.D.
Hospitalist
1201 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2000

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 Ketan Sharma's NPI number?

The NPI number for Ketan Sharma is 1376982686. It was assigned to this individual provider in the NPPES registry on June 19, 2013.

Where is Ketan Sharma located?

Ketan Sharma practices at 1201 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 257-8000.

What is Ketan Sharma's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Ketan Sharma enrolled in Medicare?

Yes. Ketan Sharma 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 Ketan Sharma accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Ketan Sharma 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 Ketan Sharma affiliated with any hospitals?

According to CMS data, Ketan Sharma is affiliated with St Luke's Regional Medical Center, St Luke's Nampa Medical Center and St Luke's Mccall.

When was this NPI record last updated?

The NPPES record for Ketan Sharma was last updated on March 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.