DR. JOHN P DURBIN M.D.
NPI 1497983787
Internal Medicine in Saint Louis, MO

Q: What is John Durbin's NPI number?

The NPI number for John Durbin is 1497983787. It was assigned to this individual provider in the NPPES registry on June 25, 2009.

Q: What is John Durbin's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for John Durbin was last updated on October 30, 2020. 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.

Active since June 25, 2009PECOS EnrolledAccepts Medicare Assignment

1035 BELLEVUE AVE, 400, SAINT LOUIS, MO 63117(314) 925-4700(314) 925-4751 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. John P Durbin M.d. NPPES

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

DR. JOHN P DURBIN M.D. (NPI 1497983787) is an individual internal medicine provider in Saint Louis, Missouri, licensed in Missouri (2014009218) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of Southern Illinois University School Of Medicine (2007).

NPPES Registry Identity

NPI1497983787

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. JOHN P DURBINCredential: M.D.

Location Address1035 BELLEVUE AVE, 400Saint Louis, MO 63117-1854

Mailing AddressPo Box 955534Saint Louis, MO 63195-5534

Phone(314) 925-4700

Fax(314) 925-4751

Sole ProprietorYes

Medical School CMSSouthern Illinois University School Of MedicineGraduated 2007

Enumeration DateJune 25, 2009

Last NPPES UpdateOctober 30, 2020

NPPES CertifiedOctober 30, 2020

✔ NPI 1497983787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in MO · 2014009218✔ Licensed in MO · 2009010808

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1035 BELLEVUE AVE, Saint Louis, MO 63117

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.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

Dr. John P Durbin 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 ID4385861012

PECOS Enrollment IDI20231122002571

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 23

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.

1,461 services630 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

701 services486 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

413 services413 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

331 services46 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.

267 services211 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

182 services146 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

167 services167 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

153 services146 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

124 services124 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

94 services41 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

78 services57 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

58 services50 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

47 services41 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

46 services13 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

32 services31 patients

Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage 90686

The quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.

25 services25 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

22 services22 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.

19 services19 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

19 services19 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

17 services17 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

14 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

14 services14 patients

Pneumococcal vaccine, 23-valent 90732

The 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420004

Location169 Ashley AveCharleston, SC 29425 · Charleston County

Emergency services Birthing friendly

Prisma Health Richland Hospital

Acute Care Hospitals · Columbia, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420018

Location5 Medical ParkColumbia, SC 29203 · Richland County

Emergency services Birthing friendly

Musc Health Columbia Medical Center Downtown

Acute Care Hospitals · Columbia, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420026

Location2435 Forest DriveColumbia, SC 29204 · Richland County

Emergency services

Kershawhealth

Acute Care Hospitals · Camden, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420048

Location1315 Roberts StreetCamden, SC 29020 · Kershaw County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63117 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

$128.28 typical visit price

range $55.65 – $169.38

Typical copayment $32.07 (range $13.91 – $42.34)

Most-billed visit code 99204

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

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 9

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

20 suppliers40 claims116 services$6.01 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers21 claims26 services$1.16 avg. paid by Medicare

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

DME-Other DME · category DE001N

2 suppliers13 claims13 services$73.44 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers13 claims39 services$27.45 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers13 claims78 services$1.68 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier14 claims14 services$43.34 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

MRS. JUDITH ANN DIETZLER RPH

Pharmacist

1035 BELLEVUE AVE, CLAYTON HEALTH SERVICES PHARMACY
SAINT LOUIS, MO 63117

St. Louis County (314) 768-8870

SSM HEALTH CARE ST LOUIS

Pharmacy (Community/Retail Pharmacy)

1035 BELLEVUE AVE
SAINT LOUIS, MO 63117

St. Louis County (314) 768-8870

SSM MEDICAL GROUP

Clinic/Center

1035 BELLEVUE AVE, SUITE 305
SAINT LOUIS, MO 63117

St. Louis County (314) 644-6161

GENERATIONS FAMILY MEDICINE PC

Family Medicine

1035 BELLEVUE AVE, SUITE 206
ST LOUIS, MO 63117

St. Louis County (314) 781-4922

WELLNESS HEALTHCARE ASSOCIATES, INC

Family Medicine

1035 BELLEVUE AVE, STE 401
SAINT LOUIS, MO 63117

St. Louis County (314) 781-0361

SSM MEDICAL GROUP

Clinic/Center

1035 BELLEVUE AVE, SUITE 502
SAINT LOUIS, MO 63117

St. Louis County (314) 638-3600

SSM MEDICAL GROUP

Clinic/Center (Medical Specialty)

1035 BELLEVUE AVE, SUITE 500
SAINT LOUIS, MO 63117

St. Louis County (314) 647-1115

DAVID ALAN WACHTER RPH

Pharmacist

1035 BELLEVUE AVE
SAINT LOUIS, MO 63117

St. Louis County (314) 768-8870

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 John Durbin's NPI number?

The NPI number for John Durbin is 1497983787. It was assigned to this individual provider in the NPPES registry on June 25, 2009.

Where is John Durbin located?

John Durbin practices at 1035 Bellevue Ave 400, Saint Louis, MO 63117. The listed phone number is (314) 925-4700.

What is John Durbin's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is John Durbin enrolled in Medicare?

Yes. John Durbin 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 John Durbin accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, Molina Healthcare and UnitedHealthcare list John Durbin 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 John Durbin affiliated with any hospitals?

According to CMS data, John Durbin is affiliated with Musc Medical Center, Prisma Health Richland Hospital, Musc Health Columbia Medical Center Downtown and Kershawhealth.

When was this NPI record last updated?

The NPPES record for John Durbin was last updated on October 30, 2020. 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.