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THE SURGERY CENTER OF ST. LOUIS, LLC
NPI 1710066014
Clinic/Center - Ambulatory Surgical in Saint Louis, MO

Active since November 06, 2006
12639 OLD TESSON RD, SUITE 130, SAINT LOUIS, MO 63128(314) 729-0785(314) 849-4637 Get Directions Write a Review

NPPES record last updated: April 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About The Surgery Center Of St. Louis, Llc NPPES

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

THE SURGERY CENTER OF ST. LOUIS, LLC (NPI 1710066014) is a healthcare organization registered as an ambulatory surgical in Saint Louis, Missouri and active in the NPI registry since November 2006. The organization lists Michael Ladevich, Ceo, as its authorized official.

NPPES Registry Identity

NPI1710066014
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameTHE SURGERY CENTER OF ST. LOUIS, LLC
Location Address12639 OLD TESSON RD, SUITE 130Saint Louis, MO 63128-2786
Mailing Address12639 Old Tesson Rd, Suite 130Saint Louis, MO 63128-2786 · (314) 729-0785 · Fax (314) 849-4637
Phone(314) 729-0785
Fax(314) 849-4637
Organization SubpartNo
Authorized OfficialMichael LadevichCeo · (314) 842-8655
Enumeration DateNovember 6, 2006
Last NPPES UpdateApril 14, 2008
✔ NPI 1710066014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in MO · 129-2
12639 OLD TESSON RD, Saint Louis, MO 63128
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Other Identifiers 2

Medicare ID-Type Unspecified000040052MO
Other490005357MO · Railroad Medicare

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. LOUISE M HILDEBOLT PA-C
Physician Assistant
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
NATHANAEL OLSON
Orthopaedic Surgery (Hand Surgery)
12639 OLD TESSON RD
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
BRIAN ANTHONY FISSEL M.D.
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
MRS. THERESA A BOXDORFER FNP
Nurse Practitioner (Family)
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
DR. DENNIS A DUSEK M.D.
Orthopaedic Surgery
12639 OLD TESSON RD, SUITE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
OLD TESSON SURGERY CENTER, L.P.
Clinic/Center (Ambulatory Surgical)
12639 OLD TESSON RD, STE 130
SAINT LOUIS, MO 63128
St. Louis County (314) 729-0785
MEDICAL IMPLANT SLOUTIONS, LLC
Durable Medical Equipment & Medical Supplies
12639 OLD TESSON RD, 116
SAINT LOUIS, MO 63128
St. Louis County (303) 840-2388
MRS. MOLLY KAY CRAWFORD OT
Occupational Therapist
12639 OLD TESSON RD, SUITE 120
SAINT LOUIS, MO 63128
St. Louis County (314) 842-3968

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 The Surgery Center Of St. Louis, LLC's NPI number?

The NPI number for The Surgery Center Of St. Louis, LLC is 1710066014. It was assigned to this organization in the NPPES registry on November 6, 2006.

Where is The Surgery Center Of St. Louis, LLC located?

The Surgery Center Of St. Louis, LLC is located at 12639 Old Tesson Rd Suite 130, Saint Louis, MO 63128. The listed phone number is (314) 729-0785.

What is The Surgery Center Of St. Louis, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

When was this NPI record last updated?

The NPPES record for The Surgery Center Of St. Louis, LLC was last updated on April 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.