Active NPI
Jimmy L Moss Jr., MD
- Anesthesiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2020009346
- Practice address
- 12634 Olive Blvd
Dept Anesthesiology
Saint Louis, MO 63141-6337 - Phone
- (800) 862-9980
- Fax
- (314) 362-1185
- NPI assigned
- Jul 7, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 2020009346 | MO | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 2020009346 | MO | |
| Anesthesiology Physician | 207L00000X | 2020009346 | MO | Primary |
Addresses
Primary practice location
12634 Olive Blvd
Dept Anesthesiology
Saint Louis, MO 63141-6337
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 862-9980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200045017 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120
12634 Olive Blvd
Saint Louis, MO 63141-6337
Phone (314) 996-8000
200 Health Care Dr
Greenville, IL 62246-1154
Phone (618) 664-1230
232 S Woods Mill Rd
Chesterfield, MO 63017-3406
Phone (314) 434-1500
4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 233-7750
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.71 of 100
- Quality
- 82.25
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.01 of 100
- Quality
- 76.14
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 76.43
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.2 of 100
- Quality
- 71.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020009346 | MO | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington University | Current | Accepting new patients | |
| Washington University | Current | Accepting new patients | |
| Cep America Illinois Intensivists | Critical Care Medicine | Current | Accepting new patients |
| Washington University Physicians in Illinois, Inc | Current | Accepting new patients | |
| Physician Specialists of St Lukes LLC | Critical Care Medicine | Current | Accepting new patients |
| Cep America Illinois Intensivists | Critical Care Medicine | Current | Accepting new patients |
| Washington University Physicians in Illinois, Inc. | Current | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407
200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194
1418 Cross St
Ste 160
Shiloh, IL 62269
Phone (618) 607-1320
4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750
1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966
660 S Euclid Ave
#8054
Saint Louis, MO 63110
Phone (314) 286-1045
12634 Olive Blvd
Saint Louis, MO 63141
Phone (314) 434-0600
232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030
Interoperability endpoints
- jmoss520276@direct.carenet.org
- jmossmd228239@carlehiedirect.net
- jimmy.moss@dekalbep.gadirect.net
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Chesterfield, MO
- NPI 1235168410
Critical Care Medicine
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1528005642
-
- Critical Care Medicine (Internal Medicine) Physician
- Elgin, IL
- NPI 1821641499
-
- Multi-Specialty Clinic/Center
- O Fallon, IL
- NPI 1477076263
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
-
- Critical Care Medicine (Internal Medicine) Physician
- Kankakee, IL
- NPI 1174320873
-
- Multi-Specialty Clinic/Center
- Belleville, IL
- NPI 1811497043
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
-
- General Acute Care Hospital
- Belleville, IL
- NPI 1982796181
-
- General Acute Care Hospital
- O Fallon, IL
- NPI 1629057302
-
- Rural Health Clinic/Center
- Breese, IL
- NPI 1013002658
Hospital
-
- General Acute Care Hospital
- Breese, IL
- NPI 1457319154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1275845208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412011",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742011",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12634 OLIVE BLVD",
"address_2": "DEPT ANESTHESIOLOGY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416337",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "JIMMY",
"middle_name": "L",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-07",
"last_updated": "2026-08-11",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "MO",
"license": "2020009346",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MO",
"license": "2020009346",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "2020009346",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200045017",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "12634 Olive Blvd",
"address_2": "Dept Anesthesiology",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631416337",
"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 Aug 11, 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.