Individual provider Active NPI

Jacob Zembles, MD

  • Rheumatology Physician
  • Ballwin, MO
National Provider Identifier
1285164228
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2020025235 Issued in MO
Practice address
15945 Clayton Rd
Suite 170
Ballwin, MO 63011-2490
Phone
(636) 256-5070
Fax
(636) 256-5066
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2020025235 MO Primary

Addresses

Primary practice location

15945 Clayton Rd
Suite 170
Ballwin, MO 63011-2490

Mailing address

15945 Clayton Rd Suite 170
Ballwin, MO 63011-2490
Phone (636) 256-5070

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200824002166 MO Practitioner - Internal MedicinePractitioner - Hospitalist 2163792698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

15945 Clayton Rd
Ballwin, MO 63011-2490
Phone (636) 256-5070

15945 Clayton Rd
Suite 360C
Ballwin, MO 63011-2382
Phone (636) 256-5090

621 S New Ballas Rd
Suite 189a
Saint Louis, MO 63141-8255
Phone (314) 251-6335

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Internal Medicine CurrentSince Aug 7, 2023 Accepting new patients
Mercy Hospitals East Communities Internal Medicine Past Accepting new patients

Locations

15945 Clayton Rd
Ste 170
Ballwin, MO 63011
Phone (636) 256-5070

15945 Clayton Rd
Ste 120B
Ballwin, MO 63011
Phone (636) 256-5070

15945 Clayton Rd
Ste 120
Ballwin, MO 63011
Phone (636) 256-5000

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Organizations & group practices 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1285164228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD SUITE 170",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112490",
            "telephone_number": "636-256-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD",
            "address_2": "SUITE 170",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112490",
            "telephone_number": "636-256-5070",
            "fax_number": "636-256-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMBLES",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-11-11",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "2020025235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "3 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652015276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.