Individual provider Active NPI

Jimmy L Moss Jr., MD

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1275845208
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2020009346 Issued in MO
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

Updated by the provider on Aug 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200045017MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
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, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170727003913 IL Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Anesthesiology 0143457721 Reassigns benefits to 2 organizations
I20200505001648 MO Practitioner - Critical Care (Intensivists) 0143457721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
Physician Specialists of St Lukes LLCGroup PAC ID 1557366960, 77 clinicians

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 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.01 of 100Reported as group
Quality
76.14
Promoting interoperability
99
Improvement activities
40
Cost
76.43

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
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

LicenseStateTypeSpecialty
2020009346MOMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Apr 1, 2020 Accepting new patients
Washington University CurrentSince Apr 1, 2020 Accepting new patients
Cep America Illinois Intensivists Critical Care Medicine CurrentSince Jul 1, 2017 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Physician Specialists of St Lukes LLC Critical Care Medicine CurrentSince Apr 30, 2023 Accepting new patients
Cep America Illinois Intensivists Critical Care Medicine CurrentSince Jul 1, 2017 Accepting new patients
Washington University Physicians in Illinois, Inc. CurrentSince Feb 7, 2024 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

  • Direct secure messaging: jmoss520276@direct.carenet.org
  • Direct secure messaging: jmossmd228239@carlehiedirect.net
  • Direct secure messaging: 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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.