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SCOTT JOHANN ARBAUGH M.D.
NPI 1861553513
Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry in O Fallon, MO

Active since December 13, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
9979 WINGHAVEN BLVD, STE 202, O FALLON, MO 63368(636) 695-4554(636) 695-3099 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 10, 2026, Nov 8, 2016 (2 updates tracked since 2016).

About Scott Johann Arbaugh M.d. NPPES

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

SCOTT JOHANN ARBAUGH M.D. (NPI 1861553513) is an individual behavioral neurology & neuropsychiatry provider in O Fallon, Missouri, licensed in Missouri (R5G44) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of Saint Louis University School Of Medicine (1985).

NPPES Registry Identity

NPI1861553513
Entity TypeIndividualMale
Primary Taxonomy2084B0040X
Provider Legal NameSCOTT JOHANN ARBAUGHCredential: M.D.
Location Address9979 WINGHAVEN BLVD, STE 202O Fallon, MO 63368-3628
Mailing Address9979 Winghaven Blvd, Ste 202O Fallon, MO 63368-3628 · (636) 695-4554 · Fax (636) 695-3099
Phone(636) 695-4554
Fax(636) 695-3099
Sole ProprietorYes
Medical School CMSSaint Louis University School Of MedicineGraduated 1985
Enumeration DateDecember 13, 2006
Last NPPES UpdateAugust 10, 20262 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1861553513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Behavioral Neurology & NeuropsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084B0040X
Licenses✔ Licensed in MO · R5G44✔ Licensed in IL · 036-078716
Definition
Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues.
9979 WINGHAVEN BLVD, O Fallon, MO 63368
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica, Oscar Insurance Company 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

Scott Johann Arbaugh 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 ID547217622
PECOS Enrollment IDI20050405000663, I20120118000547
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 Reassignments

2

Medicare enrollment records show Scott Arbaugh reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northwest Psychiatric Associates, Ltd
0.1 mi
Psychiatry
9979 WINGHAVEN BLVD STE 204
O Fallon, MO 63368
  • Reassigned Medicare billing, Illinois and Missouri enrollments
  • 3 clinicians in this Medicare group
NPI 1962563429 (636) 695-4554
Lake Substance Abuse Solutions LLC
273 mi
Psychiatric/Mental Health
1507 SPRING ST
Jeffersonville, IN 47130
  • Reassigned Medicare billing, Illinois enrollment
  • 2 clinicians in this Medicare group
NPI 1124598669 (833) 525-3727

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 4

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.
1,284 services356 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
81 services46 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.
49 services34 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.
39 services39 patients

Hospital Affiliations CMS Care Compare 5

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

St Josephs Hospital

Acute Care Hospitals · Breese, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140145
Location9515 Holy Cross LnBreese, IL 62230 · Clinton County
Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number141336
Location12866 Troxler AvenueHighland, IL 62249 · Madison County
Emergency services

Osf Saint Clare Medical Center

Critical Access Hospitals · Princeton, IL
OwnershipGovernment - Local
CMS Certification Number141337
Location530 Park Avenue EastPrinceton, IL 61356 · Bureau County
Emergency services

Fayette County Hospital

Critical Access Hospitals · Vandalia, IL
OwnershipVoluntary non-profit - Other
CMS Certification Number141346
Location650 W Taylor StVandalia, IL 62471 · Fayette County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63368 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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Other Providers at the Same Location NPPES 6

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

CHERYL HELD D.D.S., M.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
9979 WINGHAVEN BLVD, STE. 200
O FALLON, MO 63368
St. Charles County (636) 561-5550
DR. DENNIS SENDEROVICH D.D.S.
Dentist (General Practice)
9979 WINGHAVEN BLVD, 202
O FALLON, MO 63368
St. Charles County (636) 561-7072
MICHAEL DANTER M.D.
Pediatrics
9979 WINGHAVEN BLVD, SUITE 206
O FALLON, MO 63368
St. Charles County (636) 561-5291
WILLIAM STUART ADAMS M.D.
Pediatrics
9979 WINGHAVEN BLVD, SUITE 206
O FALLON, MO 63368
St. Charles County (636) 561-5291
WILLOW TREE MENTAL HEALTH CENTER, LLC
Psychiatry & Neurology (Child & Adolescent Psychiatry)
9979 WINGHAVEN BLVD, SUITE 202
O FALLON, MO 63368
St. Charles County (636) 695-2690
WINGHAVEN CHIROPRACTIC PC
Chiropractor
9979 WINGHAVEN BLVD, SUITE 204
O FALLON, MO 63368
St. Charles County (636) 695-2100

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 Scott Arbaugh's NPI number?

The NPI number for Scott Arbaugh is 1861553513. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Scott Arbaugh located?

Scott Arbaugh practices at 9979 Winghaven Blvd Ste 202, O Fallon, MO 63368. The listed phone number is (636) 695-4554.

What is Scott Arbaugh's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Behavioral Neurology & Neuropsychiatry, with taxonomy code 2084B0040X.

Is Scott Arbaugh enrolled in Medicare?

Yes. Scott Arbaugh 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.

Which organizations bill Medicare for Scott Arbaugh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Scott Arbaugh reassigns Medicare benefits to 2 organizations: Northwest Psychiatric Associates, Ltd (O Fallon, MO) and Lake Substance Abuse Solutions LLC (Jeffersonville, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Scott Arbaugh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Scott Arbaugh accept?

Health plans from Anthem Blue Cross and Blue Shield, Medica, Oscar Insurance Company and UnitedHealthcare list Scott Arbaugh 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 Scott Arbaugh affiliated with any hospitals?

According to CMS data, Scott Arbaugh is affiliated with St Josephs Hospital, Memorial Hospital, St Joseph's Hospital, Osf Saint Clare Medical Center and Fayette County Hospital.

When was this NPI record last updated?

The NPPES record for Scott Arbaugh was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.