Individual provider Active NPI

Clayton R Vogt

  • Physician Assistant
  • Bridgeton, MO
National Provider Identifier
1457125643
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2023049525 Issued in MO
Practice address
12266 De Paul Dr Ste 305
Bridgeton, MO 63044-2514
Phone
(314) 770-0991
NPI assigned
Nov 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2023049525 MO Primary

Addresses

Primary practice location

12266 De Paul Dr Ste 305
Bridgeton, MO 63044-2514

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cvogt498907@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20231221003215 MO Practitioner - Physician Assistant 9335599901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1035 Bellevue Ave
Suite 500
Saint Louis, MO 63117-1843
Phone (314) 925-4770

Hospital & facility affiliations

  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023049525MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Dec 19, 2023 Accepting new patients
SSM Medical Group Inc. CurrentSince Dec 19, 2023 Accepting new patients

Locations

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

12266 De Paul Dr
Ste 305
Bridgeton, MO 63044
Phone (314) 770-0991

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1457125643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DE PAUL DR STE 305",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-770-0991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12303 De Paul Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442512",
            "country_code": "US",
            "telephone_number": "314-344-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOGT",
        "first_name": "CLAYTON",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023049525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cvogt498907@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cvogt498907@direct-ehr-ssmhc.com",
            "address_1": "12266 De Paul Dr Ste 305",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "12266 De Paul Dr Ste 305",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.