| Dr Samuel Mearl Medaris, MD | |
|
501 W Pine St, Farmington, MO 63640-1439 | |
| (573) 756-8888 | |
| (573) 701-9547 |
| Full Name | Dr Samuel Mearl Medaris |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 23 Years |
| Location | 501 W Pine St, Farmington, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720159346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 40298 (Iowa) | Secondary |
| 207Y00000X | Otolaryngology | 23454 (Nebraska) | Secondary |
| 207Y00000X | Otolaryngology | 2020000124 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Perry County Memorial Hospital | Perryville, MO | Hospital |
| Memorial Hospital | Chester, IL | Hospital |
| Ste Genevieve County Memorial Hospital | Sainte genevieve, MO | Hospital |
| Parkland Health Center | Farmington, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mercy Hospital Perry | 1153777826 | 100 |
| Ste Genevieve County Memorial Hospital | 3274432802 | 73 |
| Urology Of St. Louis, Inc | 6204723786 | 102 |
| Mercy Hospital Perry | 1153777826 | 100 |
| Ste Genevieve County Memorial Hospital | 3274432802 | 73 |
| Entity Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619026580 PECOS PAC ID: 3274432802 Enrollment ID: O20040204000815 |
| Entity Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730238551 PECOS PAC ID: 3274432802 Enrollment ID: O20040310001286 |
| Entity Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801817416 PECOS PAC ID: 3274432802 Enrollment ID: O20040617000089 |
| Entity Name | Sound Health Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811988611 PECOS PAC ID: 0446227821 Enrollment ID: O20040915000031 |
| Entity Name | Urology Of St. Louis, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528017191 PECOS PAC ID: 6204723786 Enrollment ID: O20050629000005 |
| Entity Name | Mercy Hospital Perry |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063117158 PECOS PAC ID: 1153777826 Enrollment ID: O20231101001515 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Samuel Mearl Medaris, MD 1010 Old Des Peres Rd, Des Peres, MO 63131-1865 Ph: (314) 729-0077 | Dr Samuel Mearl Medaris, MD 501 W Pine St, Farmington, MO 63640-1439 Ph: (573) 756-8888 |
Justin W. Roberts, DO Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 501 West Pine Street, Farmington, MO 63640 Phone: 573-756-8888 Fax: 866-291-5617 |