Susan J Ameiss, PA-C

Individual provider Active NPI Physician Assistant · Saint Louis, MO

NPI 1245565415 · NPPES record last updated Nov 10, 2020

Key facts

NPI
1245565415
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
2009027331 (MO)
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 577-5631
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
085.005841ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Emergency Physicians LLP Emergency Medicine Current
since Jul 25, 2017
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

  • Direct secure messaging: sameiss23630@direct-ehr-ssmhc.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.005841 IL
Physician Assistant 363A00000X 2009027331 MO Yes
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

TypeEndpointUseAffiliation
Direct Messaging Address sameiss23630@direct-ehr-ssmhc.com Direct

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Physician Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.