BLUETAIL MEDICAL GROUP, LLC. — NPI 1285986398 (Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) in CHESTERFIELD, MO)

CMS-1500 Box 24J / 33a • NPI

1285986398

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207XX0005X (CMS 02)

Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)

Box 32 Service Location & ZIP+4

13353 OLIVE BLVD, CHESTERFIELD, MO, 63017-3108

✓ 9-Digit EDI 837 ZIP+4 (63017-3108)

Practice Phone & Referral Fax

(636) 778-2900

Fax: (636) 778-2828

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1285986398 (BLUETAIL MEDICAL GROUP, LLC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1285986398` (NPI-2 Organization / Facility)
Provider / Legal Name	BLUETAIL MEDICAL GROUP, LLC.
Plain-English Specialty	Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) NUCC Code: `207XX0005X` (Orthopaedic Surgery, Sports Medicine)
Certifying / Licensing Body	American Board of Orthopaedic Surgery (ABOS)
Practice Location Address	13353 OLIVE BLVD, CHESTERFIELD, MO, 63017-3108
Practice Telephone / Fax	Tel: (636) 778-2900 \| Fax: (636) 778-2828
Administrative Mailing Address	PO BOX 11665, BELFAST, ME, 04915-4007
Enumeration & Last Sync	Enumerated: 2012-10-12 \| CMS Record Updated: 2025-11-17
Authorized Official	JOE O'NEIL (Practice Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

13353 OLIVE BLVD, CHESTERFIELD, MO, 63017-3108

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Plain-English Taxonomy & CMS Crosswalk (207XX0005X)

What Does Taxonomy Code 207XX0005X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207XX0005X translates to:
"Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 20 (Physician/Orthopedic Surgery) • CMS Code 23 (Physician/Sports Medicine)
Certifying / Accrediting Authority: American Board of Orthopaedic Surgery (ABOS)
Clinical Scope: Severe knee or hip arthritis, bone fractures, torn ligaments or meniscus, rotator cuff shoulder pain, or persistent back and sciatica pain.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BLUETAIL MEDICAL GROUP, LLC.)

Typical CPT / Diagnostic Procedures:

Total Knee Arthroplasty (CPT 27447) & Total Hip Arthroplasty (CPT 27130)
Arthroscopic Rotator Cuff & ACL Ligament Reconstruction
Intra-Articular Corticosteroid & Hyaluronic Acid Joint Injections (CPT 20610)
Fracture Reduction, Internal Fixation & Carpal Tunnel Release

Common Therapeutic Classes:

NSAIDs & Selective COX-2 Inhibitors (Meloxicam, Celecoxib, Naproxen)
Intra-Articular Triamcinolone Acetonide & Methylprednisolone
Postoperative Venous Thromboembolism (VTE) Prophylaxis (Apixaban, Rivaroxaban)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261Q00000X` — Clinic/Center Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`207XX0005X` — Orthopaedic Surgery, Sports Medicine Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: MO \| License: `LC1262307` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BLUETAIL MEDICAL GROUP, LLC. (NPI #1285986398)