Mattis Road Surgery Center LLC
NPI 1720969504ActiveOrganization· Surgery· Saint Louis, MO
Surgery in Saint Louis, Missouri, registered in NPPES in September 2025. The authorized official on file is John Kessler, Administrator.
Overview
| NPI | 1720969504 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 9, 2025 |
| Last updated in NPPES | Sep 9, 2025 |
| Certified by provider | Sep 9, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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