SEAN LEWIS EDELSTEIN MD
NPI 1679520605
Ophthalmology in Saint Louis, MO

Q: What is Sean Edelstein's NPI number?

The NPI number for Sean Edelstein is 1679520605. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Q: What is Sean Edelstein's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Edelstein was last updated on January 19, 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.

Active since May 27, 2006PECOS EnrolledAccepts Medicare Assignment

80.42/100

CMS Quality Rating

1225 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 977-5200(314) 977-9910 Get Directions Write a Review

NPPES record last updated: January 19, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 19, 2021, Nov 5, 2020 (2 updates tracked since 2020).

On this page

About Sean Lewis Edelstein Md NPPES

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

SEAN LEWIS EDELSTEIN MD (NPI 1679520605) is an individual ophthalmology provider in Saint Louis, Missouri, licensed in Missouri (2005019369) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm Health Saint Louis University Hospital, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1679520605

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameSEAN LEWIS EDELSTEINCredential: MD

Location Address1225 S GRAND BLVDSaint Louis, MO 63104-1016

Mailing Address1008 S Spring AveSaint Louis, MO 63110-2520 · (314) 977-4010 · Fax (314) 977-3495

Phone(314) 977-5200

Fax(314) 977-9910

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateMay 27, 2006

Last NPPES UpdateJanuary 19, 20212 updates tracked since enumeration

NPPES CertifiedJanuary 7, 2021

✔ NPI 1679520605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in MO · 2005019369

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 2005019369 (MO)

Also ListedInternal MedicineTaxonomy 207R00000X · License 2005019369 (MO)

1225 S GRAND BLVD, Saint Louis, MO 63104

Open in Google Maps ↗

Other Identifiers 2

Medicaid1679520605MO

Medicaid200839009MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan 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

Sean Lewis Edelstein 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 ID8820023922

PECOS Enrollment IDI20050928000003, I20100129000555

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 21

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 complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

122 services117 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

108 services68 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.

92 services72 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

90 services60 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.

65 services47 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

60 services43 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

40 services38 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

38 services38 patients

Microfluid analysis of tears 83861

Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.

37 services19 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

29 services28 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

29 services29 patients

Ct scan of cornea 92025

28 services24 patients

Transplantation of outer layer of corneal tissue 65756

The transplantation of the outer layer of corneal tissue is a procedure to replace damaged or diseased corneal tissue with healthy tissue from a donor. This can improve vision and alleviate pain or discomfort.

18 services17 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

18 services18 patients

Measurement of corneal curvature and depth of eye 92136

18 services16 patients

Established patient complete exam of visual system 92014

16 services16 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

16 services16 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.

15 services15 patients

Preparation of corneal tissue for transplant 65757

Preparation of corneal tissue for transplant involves carefully removing the cornea from a donor eye, examining it for health and clarity, and storing it in a special solution until the transplant. This process ensures a safe and successful transplant.

14 services13 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

12 services12 patients

New patient complete exam of visual system 92004

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Ssm Health Saint Louis University Hospital

Acute Care Hospitals · Saint Louis, MO

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260105

Location3635 Vista AveSaint Louis, MO 63110 · St. Louis City County

Emergency services

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

$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

$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.

80.42/100

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

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

34.74

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.

DR. MATTHEW RUSSELL SMEDS MD

Surgery (Vascular Surgery)