Gregorius Resuma Penilla, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36678 Issued in MO

Practice address

1345 Smizer Mill Rd Ste 1100
Fenton, MO 63026-7305

Phone

(636) 496-5040

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• SSM Health Care St. Louis

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1336387836
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1962572396
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1023024973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 SMIZER MILL RD STE 1100",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267305",
            "telephone_number": "636-496-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14309 Manchester Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "MO",
            "postal_code": "630114050",
            "country_code": "US",
            "telephone_number": "636-227-8880",
            "fax_number": "636-227-8890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENILLA",
        "first_name": "GREGORIUS",
        "middle_name": "RESUMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "36678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gpenilla9855@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "gpenilla9855@direct-ehr-ssmhc.com",
            "address_1": "1345 Smizer Mill Rd Ste 1100",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630267305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1345 Smizer Mill Rd Ste 1100",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630267305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pasia Medical Rehabilitation, LLC
• Enrique Pastrana, M.D.
• Aman Kanti Patel, DO
• Patients First Health Care LLC
• Rachel Pence
• Timothy James Perkins, MSN, FNP-BC
• Clayton R Perry, MD
• Peter J Anderson, MD PC
• Jeffrey E Petersen, MD
• Maryellen Petrie, DPT

• Internal Medicine Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.