Active NPI
Susan J Ameiss, PA-C
- Physician Assistant
- Saint Louis, MO
National Provider Identifier
1245565415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2009027331
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 577-5631
- NPI assigned
- Oct 6, 2009
- Last updated
- Nov 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.005841 | IL | |
| Physician Assistant | 363A00000X | 2009027331 | MO | Primary |
| Emergency Medicine Physician | 207P00000X | 2009027331 | MO |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5631
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sameiss23630@direct-ehr-ssmhc.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.005841 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uptown Emergency Physicians LLP | Emergency Medicine | Current | Accepting new patients |
| SSM Health Care St. Louis | Emergency Medicine | Past | Accepting new patients |
| BC Missouri Emergency Physicians, LLP | Emergency Medicine | Past | Accepting new patients |
Locations
1103 Belt Line Rd
Collinsville, IL 62234
Phone (618) 344-2273
Interoperability endpoints
- sameiss23630@direct-ehr-ssmhc.com
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Bethalto, IL
- NPI 1184016313
-
- Emergency Medicine Physician
- Farmington, MO
- NPI 1396760062
-
dba SSM Health St. Mary's Hospital Physician Billing
- Emergency Medicine Physician
- Saint Louis, MO
- NPI 1366400855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1245565415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-577-5631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-577-5631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMEISS",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-06",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.005841",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2009027331",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2009027331",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sameiss23630@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "sameiss23630@direct-ehr-ssmhc.com",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.