Individual provider Active NPI

Shanna Marie Zwick, PA

  • Surgical Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1124361605
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2022023073 Issued in MO
Practice address
1044 N Mason Rd
Div Surg Colon/Rectal, Ste 310
Saint Louis, MO 63141-6431
Phone
(314) 454-7177
Fax
(888) 425-7946
NPI assigned
Apr 2, 2013
Sex
Female
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
Surgical Physician Assistant 363AS0400X 2022023073 MO Primary

Addresses

Primary practice location

1044 N Mason Rd
Div Surg Colon/Rectal, Ste 310
Saint Louis, MO 63141-6431

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-7177

Other identifiers 1

IdentifierTypeStateIssuer
220031343MedicaidMO

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
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

Enrollment IDStateProvider typePAC IDDetails
I20130730000815 MO Practitioner - Physician Assistant 7113168352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1044 N Mason Rd
Medical Office 4
Saint Louis, MO 63141-6310
Phone (314) 362-2280

660 S Euclid Ave
Campus Box 8109
St Louis, MO 63110-1624
Phone (314) 362-7841

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 6, 2022 Accepting new patients
Washington University CurrentSince Jul 6, 2022 Accepting new patients

Locations

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

1044 N Mason Rd
Ste 310
Saint Louis, MO 63141
Phone (314) 454-7177

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1124361605",
    "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": "314-454-7177",
            "fax_number": "888-425-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N MASON RD",
            "address_2": "DIV SURG COLON/RECTAL, STE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416431",
            "telephone_number": "314-454-7177",
            "fax_number": "888-425-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWICK",
        "first_name": "SHANNA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2022023073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220031343",
            "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": "1044 N Mason Rd",
            "address_2": "Div Surg Colon/Rectal, Ste 310",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.