Active NPI
Benjamin Jason Barton, M.P.T
- Physical Therapist
- Ellisville, MO
National Provider Identifier
1043439029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2004030104
- Practice address
- 16075 Manchester Rd
Ellisville, MO 63011-2103 - Phone
- (636) 256-0880
- Fax
- (636) 256-9153
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2004030104 | MO | Primary |
Addresses
Primary practice location
16075 Manchester Rd
Ellisville, MO 63011-2103
Mailing address
16075 Manchester Rd
Ellisville, MO 63011-2103
Phone (636) 256-0880
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 705347 | Other | MO | UHC |
| 724945 | Other | MO | HEALTHLINK |
| 185215 | Other | MO | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260303002283 | MO | Practitioner - Physical Therapist in Private Practice | 4385126093 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
524 S Crescent Dr
Kirkwood, MO 63122-4629
Phone (314) 686-1309
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004030104 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smart Rehab, LLC | Physical Therapist | Current | Accepting new patients |
| Aging Well Health Care, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Saint Louis, MO
- NPI 1215936588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043439029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16075 MANCHESTER RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112103",
"telephone_number": "636-256-0880",
"fax_number": "636-256-9153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16075 MANCHESTER RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112103",
"telephone_number": "636-256-0880",
"fax_number": "636-256-9153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTON",
"first_name": "BENJAMIN",
"middle_name": "JASON",
"credential": "M.P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2004030104",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "705347",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "724945",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "185215",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.