Individual provider Active NPI

Witoon Ruamwijitphong, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
National Provider Identifier
1063742633
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2010005623 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Dept Anesthesiology
Saint Louis, MO 63110-1003
Phone
(800) 862-9980
Fax
(314) 362-1185
NPI assigned
Jan 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2010005623 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Dept Anesthesiology
Saint Louis, MO 63110-1003

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 862-9980

Other identifiers 1

IdentifierTypeStateIssuer
914254909MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100624000195 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325179013 Reassigns benefits to 6 organizations
I20140611001888 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325179013 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

Hospital & facility affiliations

  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Anderson Hospital Hospital, Maryville, IL, CCN 140289
  • Memorial Hospital Hospital, Belleville, IL, CCN 140185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2010005623MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SW Anesthesia LLC CurrentSince May 29, 2023 Accepting new patients
Allied Anesthesia Associates, P.C. CurrentSince Mar 15, 2014 Accepting new patients
Diversified Medical Services LLC CurrentSince May 15, 2024 Accepting new patients
South County Anesthesia Associates, LTD CurrentSince Feb 24, 2010 Accepting new patients
Gateway Anesthesia Group LLC CurrentSince May 27, 2023 Accepting new patients
Dreamland Uap Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2017 Accepting new patients
Washington University CurrentSince Sep 19, 2017 Accepting new patients
Washington University CurrentSince Sep 19, 2017 Accepting new patients
South County Anesthesia Associates, LTD. CurrentSince Feb 24, 2010 Accepting new patients
Digestive Health Specialists, LLC CurrentSince Oct 1, 2023 Accepting new patients
Novamed Eye Surgery Center of North County, LLC Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

403 S Kennedy Dr
Bradley, IL 60915
Phone (815) 928-9999

5023 N Illinois St
Fairview Hts, IL 62208
Phone (618) 239-0678

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

100 Village Sq
Hazelwood, MO 63042
Phone (314) 355-4010

3800 S Whitney Ave
Ste 100
Independence, MO 64055

1 Barnes Jewish Hospital Plz
#P
Saint Louis, MO 63110
Phone (618) 474-1074

10296 Big Bend Rd
Saint Louis, MO 63122
Phone (314) 543-5970

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

5139 Mattis Rd
Ste 100
Saint Louis, MO 63128
Phone (314) 207-8939

450 N New Ballas Rd
Ste 103
Saint Louis, MO 63141
Phone (314) 991-0776

660 S Euclid Ave
#8054
Saint Louis, MO 63110
Phone (314) 286-1045

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

12345 W Bend Dr
Ste 201
Saint Louis, MO 63128
Phone (314) 722-2530

11525 Olde Cabin Rd
Ste 101
Saint Louis, MO 63141
Phone (314) 400-9999

660 S Euclid Ave
#C
Saint Louis, MO 63110

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1063742633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUAMWIJITPHONG",
        "first_name": "WITOON",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2025-04-17",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2010005623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914254909",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.

Verify at the official NPI Registry.