Individual provider Active NPI

Patrick B Sandiford, M.D.

  • Pulmonary Disease Physician
  • Bridgeton, MO
National Provider Identifier
1154389336
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MDR3K84 Issued in MO
Practice address
12255 De Paul Dr Ste 500
Bridgeton, MO 63044-2515
Phone
(314) 209-5180
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MDR3K84 MO
Pulmonary Disease Physician 207RP1001X MDR3K84 MO Primary

Addresses

Primary practice location

12255 De Paul Dr Ste 500
Bridgeton, MO 63044-2515

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

201 First Executive Ave
St Peters, MO 63376-1697
Phone (636) 441-2600

Other identifiers 1

IdentifierTypeStateIssuer
206930919MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address psandiford21705@direct-ehr-ssmhc.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804001655 MO Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7810968534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Washington University School of Medicine, 1987
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)

12255 De Paul Dr
Suite 500
Bridgeton, MO 63044-2515
Phone (314) 291-5180

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MDR3K84MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. Critical Care Medicine CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St. Louis Critical Care Medicine Past Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
Pulmonary Disease Consultants, Inc. PastSince Dec 27, 2002 Accepting new patients

Locations

12255 De Paul Dr
Ste 500
Bridgeton, MO 63044
Phone (314) 209-5180

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Interoperability endpoints

  • Direct secure messaging: psandiford21705@direct-ehr-ssmhc.com

Organizations & group practices 5

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 4

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1154389336",
    "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": "12255 DE PAUL DR STE 500",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442515",
            "telephone_number": "314-209-5180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 First Executive Ave",
            "address_purpose": "LOCATION",
            "city": "St Peters",
            "state": "MO",
            "postal_code": "633761697",
            "country_code": "US",
            "telephone_number": "636-441-2600",
            "fax_number": "636-447-7612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDIFORD",
        "first_name": "PATRICK",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "MDR3K84",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "MDR3K84",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206930919",
            "state": "MO"
        }
    ],
    "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": "12255 De Paul Dr Ste 500",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psandiford21705@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "psandiford21705@direct-ehr-ssmhc.com",
            "address_1": "12255 De Paul Dr Ste 500",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.