Samuel R Nathan, PA-S

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2024027697 Issued in MO

Practice address

801 Medical Dr Ste 400
Wentzville, MO 63385-3824

Phone

(636) 332-8455

NPI assigned

Apr 22, 2024

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

Other names 1

• Samuel R Nathan Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: snathan514107@direct-ehr-ssmhc.com
• Direct secure messaging: snathan51407@direct-ehr-ssmhc.com

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
  Medicare reassignment Care Compare group
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• SSM Medical Group, Inc.

  • Clinic/Center
  • O Fallon, MO
  • NPI 1851896146
  NPD

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1083469142",
    "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": "801 MEDICAL DR STE 400",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853824",
            "telephone_number": "636-332-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 Kisker Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633048787",
            "country_code": "US",
            "telephone_number": "636-332-8455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2024027697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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": "801 Medical Dr Ste 400",
            "city": "Wentzville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633853824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snathan51407@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "snathan51407@direct-ehr-ssmhc.com",
            "address_1": "801 Medical Dr Ste 400",
            "city": "Wentzville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633853824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "NATHAN",
            "middle_name": "R",
            "credential": "PA-S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leticia Murillo, COTA/L
• Bethany Joy Murnane, LMSW
• Ophelia Ann Murphy, M.A.,CCC-SLP
• Carri Marie Murray, PT
• Sylvia Mutuma
• Rosanne Naunheim, MD
• Natalie Nicole Nekouian, D.O.
• Laurie A Nelson, PT
• Elizabeth Kay Newman, CF-SLP
• Robert D Newman, DD PHD

• Physician Assistant in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.