JOSHUA FERNELIUS MD
NPI 1861020497
Hospitalist in Saint Louis, MO

Q: What is Joshua Fernelius's NPI number?

The NPI number for Joshua Fernelius is 1861020497. It was assigned to this individual provider in the NPPES registry on March 30, 2020.

Q: What is Joshua Fernelius's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Joshua Fernelius was last updated on May 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 30, 2020PECOS EnrolledAccepts Medicare Assignment

88.92/100

CMS Quality Rating

1201 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 257-8000(314) 977-6164 Get Directions Write a Review

NPPES record last updated: May 31, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Joshua Fernelius Md NPPES

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

JOSHUA FERNELIUS MD (NPI 1861020497) is an individual hospitalist provider in Saint Louis, Missouri, licensed in Missouri (2023010147) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - St Louis, and is a graduate of Saint Louis University School Of Medicine (2020).

NPPES Registry Identity

NPI1861020497

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameJOSHUA FERNELIUSCredential: MD

Location Address1201 S GRAND BLVDSaint Louis, MO 63104-1016

Mailing Address1402 S Grand Blvd # 12Saint Louis, MO 63104-1004 · (314) 577-8762 · Fax (314) 268-5108

Phone(314) 257-8000

Fax(314) 977-6164

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2020

Enumeration DateMarch 30, 2020

Last NPPES UpdateMay 31, 2024

NPPES CertifiedMay 31, 2024

✔ NPI 1861020497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in MO · 2023010147

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 2023010147 (MO)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

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 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

Joshua Fernelius 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 ID6709202898

PECOS Enrollment IDI20230608003295

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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

159 services81 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

81 services38 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

20 services20 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

18 services18 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

17 services17 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

15 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260091

Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County

Emergency services Birthing friendly

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

$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.

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.

88.92/100

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

Scored as part of a group practice

Quality

84.72

Promoting Interoperability

100

Improvement Activities

Cost

45.01

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)