Active NPI
Traci N St Clair, P.A.-C.
- Surgical Physician Assistant
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 2003002310
- Practice address
- 1229 E Seminole St
Springfield, MO 65804-2227 - Phone
- (417) 820-5610
- Fax
- (417) 820-5588
- NPI assigned
- Apr 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 2003002310 | MO | Primary |
Addresses
Primary practice location
1229 E Seminole St
Springfield, MO 65804-2227
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2003002310 | Other | MO | STATE LICENSE |
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060306000066 | MO | Practitioner - Physician Assistant | 3476568965 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
1235 E Cherokee St
Springfield, MO 65804-2203
1605 Martin Springs Dr
Rolla, MO 65401-2980
2055 S Fremont Ave
Springfield, MO 65804-2206
2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905
3231 S National Ave
Springfield, MO 65807-7304
Hospital & facility affiliations
- Mercy Hospital Springfield
- Mercy Hospital Lebanon
- Mercy St Francis Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
3050 E River Bluff Blvd
Ozark, MO 65721
Phone (417) 820-5610
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
3045 S National Ave
Ste 100
Springfield, MO 65804
Phone (417) 882-1900
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Interoperability endpoints
- tstclair2931@directb.mercy.net
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
MO
-
- Durable Medical Equipment & Medical Supplies
- Rolla, MO
- NPI 1023215571
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1053373696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620",
"fax_number": "417-829-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 E SEMINOLE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042227",
"telephone_number": "417-820-5610",
"fax_number": "417-820-5588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST CLAIR",
"first_name": "TRACI",
"middle_name": "N",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-06",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MO",
"license": "2003002310",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2003002310",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.