DR. PAULO S BICALHO M.D.
NPI 1487606810
Orthopaedic Surgery in Saint Louis, MO

Q: What is Paulo Bicalho's NPI number?

The NPI number for Paulo Bicalho is 1487606810. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Q: What is Paulo Bicalho's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Paulo Bicalho was last updated on January 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since May 16, 2006PECOS EnrolledAccepts Medicare Assignment

74.42/100

CMS Quality Rating

12152 TESSON FERRY RD, SAINT LOUIS, MO 63128(314) 849-5414(314) 849-2042 Get Directions Write a Review

NPPES record last updated: January 18, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Paulo S Bicalho M.d. NPPES

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

DR. PAULO S BICALHO M.D. (NPI 1487606810) is an individual orthopaedic surgery provider in Saint Louis, Missouri, licensed in Missouri (108954) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and is a graduate of R Franklin University Of Med & Sci/chicago Medical School (1993).

NPPES Registry Identity

NPI1487606810

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. PAULO S BICALHOCredential: M.D.

Location Address12152 TESSON FERRY RDSaint Louis, MO 63128-1726

Mailing Address12639 Old Tesson Rd, Suite 115Saint Louis, MO 63128-2786 · (314) 849-0311 · Fax (314) 849-4423

Phone(314) 849-5414

Fax(314) 849-2042

Sole ProprietorNo

Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 1993

Enumeration DateMay 16, 2006

Last NPPES UpdateJanuary 18, 2013

✔ NPI 1487606810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in MO · 108954

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

12152 TESSON FERRY RD, Saint Louis, MO 63128

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Other Identifiers 9

Other3931797MO · Cigna

Medicare ID-Type Unspecified065012295MO

Other7641235MO · Aetna

OtherP00023249MO · Railroad Medicare

Other0901359MO · United Healthcare

Other133769MO · Group Health Plan

Other141956MO · Healthlink

Medicare UPING08624MO

Other177003MO · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Paulo S Bicalho M.d. 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 ID8921188178

PECOS Enrollment IDI20071231000323

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.

Medicare Billing Reassignment

Medicare enrollment records show Paulo Bicalho reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Anderson Medical Group, LLC

27 mi

General Practice

6810 STATE ROUTE 162, SUITE 215
Maryville, IL 62062

Reassigned Medicare billing, Illinois enrollment
145 clinicians in this Medicare group

NPI 1700807716 (618) 288-5711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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 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.

112 services91 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.

99 services77 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

83 services57 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

67 services59 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

60 services46 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

56 services37 patients

Hospital Affiliations CMS Care Compare 3

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

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140002

LocationOne Memorial DriveAlton, IL 62002 · Madison County

Emergency services Birthing friendly

Anderson Hospital

Acute Care Hospitals · Maryville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140289

Location6800 State Route 162Maryville, IL 62062 · Madison County

Emergency services Birthing friendly

Community Hospital Of Staunton

Critical Access Hospitals · Staunton, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141306

Location400 N Caldwell StStaunton, IL 62088 · Macoupin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63128 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.

74.42/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.31

Promoting Interoperability

Improvement Activities

Cost

56.92

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

46%413 patients2/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

91%1,931 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%202 patients4/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

88%473 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

91%973 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

40%398 patients2/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

38%820 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

32%574 patients2/55-star benchmark: 88%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 98% · 476 patients

Patients tobacco: 86% · 79 patients

97%476 patients4/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

93%973 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

2%973 patients1/55-star benchmark: 79%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 398 patients

1%398 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

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

Continuous passive motion exercise device for use on knee only E0935

DME-Other DME · category DE000N

1 supplier18 claims341 services$22.02 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 19

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

DR. PERRY KENT GEISTLER DPM

Podiatrist (Foot & Ankle Surgery)