Individual provider Active NPI

Samuel Hardin Nieman, PA

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1467344549
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025037850 Issued in MO
Practice address
10 Barnes West Dr
Div Im Medical Oncology, Ste 100
Saint Louis, MO 63141-6287
Phone
(314) 747-1171
Fax
(314) 362-3192
NPI assigned
Jul 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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 2025037850 MO Primary

Addresses

Primary practice location

10 Barnes West Dr
Div Im Medical Oncology, Ste 100
Saint Louis, MO 63141-6287

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 747-1171

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20251217002603 MO Practitioner - Physician Assistant 0749775757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

10 Barnes W Dr
Barnes Jewish W Co Siteman Cancer Ctr
Saint Louis, MO 63141-6350
Phone (314) 996-8876

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025037850MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Dec 2, 2025 Accepting new patients
Washington University CurrentSince Dec 2, 2025 Accepting new patients
Washington University Past Accepting new patients

Locations

1255 Graham Rd
Ste 101
Florissant, MO 63031

5225 Mid America Plz
Ste D115
Saint Louis, MO 63129
Phone (314) 286-2500

10 Barnes West Dr
Ste 100
Saint Louis, MO 63141
Phone (314) 205-2223

8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375

4500 Forest Park Ave
Ste 1B
Saint Louis, MO 63108

10 Barnes West Dr
Saint Louis, MO 63141
Phone (314) 996-3403

150 Entrance Way
Ste 100
Saint Peters, MO 63376
Phone (636) 916-9920

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.

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1467344549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-747-1171",
            "fax_number": "314-362-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BARNES WEST DR",
            "address_2": "DIV IM MEDICAL ONCOLOGY, STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416287",
            "telephone_number": "314-747-1171",
            "fax_number": "314-362-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMAN",
        "first_name": "SAMUEL",
        "middle_name": "HARDIN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-12-08",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025037850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "10 Barnes West Dr",
            "address_2": "Div IM Medical Oncology, Ste 100",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.