NPIMap

State of Missouri

A Medicare group practice based in Saint Louis, MO: 20 NPIs enrolled under one PECOS associate control ID (PAC ID 1456254226), with 115 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
1456254226The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Hospital, Part B Supplier - Clinic/Group Practice
Enrolled in
MO
Enrollments
12
Group size
48 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
22In 11 places

Enrollment records 12

Enrollment IDStateProvider typeNPI
O20040129000481 MO Part B Supplier - Clinic/Group Practice 1164477873
O20040218001002 MO Part B Supplier - Clinic/Group Practice 1437106705
O20041208000681 MO Part B Supplier - Clinic/Group Practice 1316991896
O20041208000473 MO Part B Supplier - Clinic/Group Practice 1710931167
O20041208000430 MO Part B Supplier - Clinic/Group Practice 1427002013
O20040609001176 MO Part B Supplier - Clinic/Group Practice 1497709083
O20071120000193 MO Part A Provider - Hospital 1104879444
O20071029000340 MO Part A Provider - Hospital 1578518239
O20071029000586 MO Part A Provider - Hospital 1104878792
O20071029000374 MO Part A Provider - Hospital 1861447526
O20071029000275 MO Part A Provider - Hospital 1730134495
O20120103000181 MO Part A Provider - Hospital 1033289897

NPIs in this group 20

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 115

Page 1 of 2

Clinicians who reassign their Medicare benefits to this group (114) or whom Care Compare lists as members (48).

Sources for this page