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
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sameiss23630@direct-ehr-ssmhc.com | Direct |
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All providers in Saint Louis, MO · Physician Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.