Justin Lynn Northcutt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085007547 Issued in IL

Practice address

12639 Old Tesson Rd.
Suite 115
St. Louis, MO 63128-2786

Phone

(314) 849-0311

Fax

(314) 849-4423

NPI assigned

Mar 17, 2020

Last updated

Nov 2, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

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 2

Specialty

Physician Assistant

Education

Saint Louis University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.northcutt@direct.signature.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signature Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1871542761
  Medicare reassignment Care Compare group NPD
• Deaconess Illinois Specialty Clinic, Inc.

  dba Deaconess IL Specialty 3331 DeYoung

  • Surgery Physician
  • Marion, IL
  • NPI 1972210235
  Medicare reassignment
• Signature Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
  • NPI 1982473153
  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  dba Deaconess IL Specialty 513 N Main St

  • Orthopaedic Surgery Physician
  • Anna, IL
  • NPI 1134836612
  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  dba Deaconess Care Group Illinois Union County

  • Hospitalist Physician
  • Anna, IL
  • NPI 1225858251

  Physician Assistant

  NPD
• Heartland Rural Healthcare, LLC

  • Family Medicine Physician
  • Marion, IL
  • NPI 1316009582
  NPD (past)
• Specialists in Medical Imaging SC

  • Diagnostic Radiology Physician
  • Olympia Fields, IL
  • NPI 1841687951

  Physician Assistant

  NPD (past)

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

• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1194351668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD.",
            "address_2": "SUITE 115",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD.",
            "address_2": "SUITE 115",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHCUTT",
        "first_name": "JUSTIN",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-17",
        "last_updated": "2026-11-02",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North County Orthopaedics, Inc.
• North Side Foot Clinic P.C.
• North Valley Nursing & Rehabilitation Center LLC
• Karen Suzanne Northcott, MSW, LCSW
• Amanda Lee Northcutt, PLPC
• Northeast Ambulance and Fire Protection District
• Northeastern Nursing & Rehabilitation Center LLC (Willowbrooke Nursing & Rehabilitation Center)
• Northern Family Adult Daycare LLC
• Northern Family Home Health Care LLC
• Northern Family in Home Services LLC

• Physician Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; 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.