Individual provider Active NPI

Tabatha Marie Stabler Sauer, PA

  • Medical Physician Assistant
  • Maryville, IL
National Provider Identifier
1346838893
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.008911 Issued in IL
Practice address
10 Professional Park Dr
Maryville, IL 62062-5672
Phone
(618) 288-7244
NPI assigned
Jan 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.008911 IL Primary

Addresses

Primary practice location

10 Professional Park Dr
Maryville, IL 62062-5672

Mailing address

6810 State Route 162 Ste 215
Maryville, IL 62062-8566
Phone (618) 391-6495

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909004531 MO Practitioner - Physician Assistant 2860887601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Saint Louis University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

5758 Telegraph Rd
Oakville, MO 63129-4244
Phone (314) 543-5996

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

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008911ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Sep 9, 2024 Accepting new patients
Mercy Clinic East Communities CurrentSince Sep 9, 2024 Accepting new patients
Malench & Malench MDS PastSince Mar 6, 2022 Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

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

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.

Hospital & facility affiliations 3

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": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1346838893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 STE 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628566",
            "telephone_number": "618-391-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROFESSIONAL PARK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625672",
            "telephone_number": "618-288-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUER",
        "first_name": "TABATHA",
        "middle_name": "MARIE STABLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.008911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.