Active NPI
Ray Bartlett, P.A.
- Physician Assistant
- Saint Charles, MO
National Provider Identifier
1194738260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 104933
- Practice address
- 723 1St Capitol Dr
Saint Charles, MO 63301-2729 - Phone
- (636) 577-1357
- Fax
- (636) 447-1202
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 104933 | MO | Primary |
Addresses
Primary practice location
723 1St Capitol Dr
Saint Charles, MO 63301-2729
Mailing address
3009 N Ballas Rd Ste 383C
Saint Louis, MO 63131-2324
Phone (314) 996-7014
Other practice location 1
3009 N Ballas Rd Ste 383C
Saint Louis, MO 63131-2324
Phone (314) 996-7014
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104933 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1285664268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633910400000",
"number": "1194738260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 N BALLAS RD STE 383C",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312324",
"telephone_number": "314-996-7014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "723 1ST CAPITOL DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012729",
"telephone_number": "636-577-1357",
"fax_number": "636-447-1202"
}
],
"practiceLocations": [
{
"address_1": "3009 N Ballas Rd Ste 383C",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631312324",
"country_code": "US",
"telephone_number": "314-996-7014",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARTLETT",
"first_name": "RAY",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2021-10-11",
"certification_date": "2021-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "104933",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3009 N Ballas Rd Ste 383C",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312324",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.