NPIMap

Organization Active NPI

SSM Health Care St. Louis

Doing business as SSM Health DePaul Hospital

  • Cardiovascular Disease Physician
  • Bridgeton, MO
National Provider Identifier
1376598599
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SSM HEALTH CARE ST. LOUIS
Doing business as
SSM Health DePaul Hospital
Practice address
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone
(314) 344-6000
Fax
(314) 344-6840
NPI assigned
May 24, 2006
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Karen Rewerts
Title
VP Finance
Phone
(314) 344-6000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Pulmonary Disease Physician 207RP1001X NU
Neonatal-Perinatal Medicine Physician 2080N0001X NU
Neurology Physician 2084N0400X NU
Trauma Surgery Physician 2086S0127X NU

Addresses

Primary practice location

12303 De Paul Dr
Bridgeton, MO 63044-2512

Mailing address

1145 Corporate Lake Dr
Saint Louis, MO 63132-2907
Phone (314) 989-2615

Other practice location 1

12277 DePaul Dr.
Bridgeton, MO 63044-2512
Phone (314) 344-7979

Other identifiers 1

IdentifierTypeStateIssuer
540494101MedicaidMO

Other names 1

  • SSM Health DePaul Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000393 MO Part B Supplier - Clinic/Group Practice 7810800737 Receives reassigned benefits from 776 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Maryland Heights, MO; O Fallon, MO; Saint Charles, MO; Florissant, MO; Saint Louis, MO; Wentzville, MO; Bridgeton, MO; Arnold, MO…

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12355 De Paul Dr
Ste 150
Bridgeton, MO 63044
Phone (314) 344-7200

3444 McKelvey Rd
Bridgeton, MO 63044
Phone (314) 291-6224

300 Medical Plz
Ste 221
Lake St Louis, MO 63367
Phone (636) 561-2229

2022 Dorsett Vlg
Maryland Heights, MO 63043
Phone (314) 520-0520

1475 Kisker Rd
Ste 125
Saint Charles, MO 63304
Phone (314) 485-1101

711 Veterans Memorial Pkwy
Ste 100
Saint Charles, MO 63303
Phone (314) 989-6838

Practitioners & affiliated clinicians

Practitioners 322

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 322

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1376598599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 CORPORATE LAKE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631322907",
            "telephone_number": "314-989-2615",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442512",
            "telephone_number": "314-344-6000",
            "fax_number": "314-344-6840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12277 DePaul Dr.",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442512",
            "country_code": "US",
            "telephone_number": "314-344-7979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SSM HEALTH CARE ST. LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "REWERTS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "314-344-6000"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540494101",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health DePaul Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health DePaul Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.