George Randolphe Wettach, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2016007356 Issued in MO

Practice address

425 S Euclid Ave
Dept Pathology
Saint Louis, MO 63110-1005

Phone

(314) 362-5641

Fax

(314) 362-0369

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Pathology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
• SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011

Merit-based Incentive Payment System (MIPS)

Final score

84.94 of 100Reported as group

Quality

68.52

Promoting interoperability

100

Improvement activities

40

Cost

72.22

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544

  Anatomic Pathology & Clinical Pathology, IL

  Medicare reassignment Care Compare group NPD
• Southeast Missouri Hospital Physicians, LLC

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD
• Parkway Pathology Group

  • Anatomic Pathology & Clinical Pathology Physician
  • Sullivan, MO
  • NPI 1750580510
  NPD (past)
• Blue Mountain Pathology Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Pendleton, OR
  • NPI 1356386684
  NPD (past)

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1336387836
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1962572396
  Care Compare affiliation
• SSM Regional Health Services

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  Care Compare affiliation

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1407077852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8118",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-5641",
            "fax_number": "314-362-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S EUCLID AVE",
            "address_2": "DEPT PATHOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101005",
            "telephone_number": "314-362-5641",
            "fax_number": "314-362-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTACH",
        "first_name": "GEORGE",
        "middle_name": "RANDOLPHE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2016007356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031776",
            "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": "425 S Euclid Ave",
            "address_2": "Dept Pathology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Westport Periodontics P.C.
• Layne Allison Wetherbee
• Darren E Wethers, MD
• Rachel A Wethers, MSW, LCSW
• Karen S Wetmore, MSW LCSW
• Noel Francis Weyerich, MD
• James P Whalen, LAC
• Jeanne L Whalen, RN
• Sydney Elyse Whalen
• Thomas R Whalen, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anatomic Pathology & Clinical Pathology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.

Verify at the official NPI Registry.