SSM Medical Group Inc.
Organization Active NPI Durable Medical Equipment & Medical Supplies · Bridgeton, MO
NPI 1477564581 · NPPES record last updated Aug 18, 2020
Key facts
- NPI
- 1477564581
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- SSM MEDICAL GROUP INC.
- Practice address
- 12255 De Paul Dr
Suite 500
Bridgeton, MO 63044 - Phone
- (314) 209-5180
- Fax
- (314) 209-5153
- NPI assigned
- Aug 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SSM MEDICAL GROUP INC.
Authorized official
- Name
- Karen Rewerts
- Title
- VP Financial Operations
- Phone
- (314) 989-2034
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 12
Member organizations 4
Practitioners 565
-
Syed A Abdul Khader, M.D.
-
Lindsey Danielle Adams, NP-C
-
Tauqir X Ahmed, MD
-
Najat A. Al-Sherri, M.D.
-
Tanvira K Alam, DO
-
Zain Ali, M.D.
-
Saad Alkaade, M.D.
-
Laura Ly Allen, N.P.
-
Amer Alshekhlee, MD
-
Kristina Marie Anderson, M.D.
-
Jordan Marie Arneaud, ACNP
-
Romila Aslam, M.D.
-
Issam Atallah, MD
-
Sara Atkinson, MSN, FNP-C
-
Getinet Degu Ayalew, M.D.
-
Elie C Azrak, MD
-
Natalie Faye Babb, FNP-BC
-
Maddison Baker, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181115000997 | MO | DME Supplier - Physician - Podiatry | 6608776299 | Practice locations: Bridgeton, MO |
National Provider Directory
- Tax ID family
- SSM Depaul Medical Group Inc
- Part of
- Eric S Colton MD
Locations
1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Podiatrist |
213E00000X | MO | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
12255 De Paul Dr
Suite 500
Bridgeton, MO 63044
Mailing address
3221 McKelvey Rd Ste 301
Bridgeton, MO 63044-2551
Phone (636) 498-5944
Other names
- SSM Health Medical Group
Other providers in Bridgeton, MO
- SSM Health Care St. Louis
- SSM Health Care St. Louis
- SSM Health Care St. Louis
- SSM Medical Group Inc.
- SSM Medical Group Inc.
- SSM Neurosciences Inc
- SSM Pharmacy @ Depaul
- St Louis County Otolaryngology LTD
- St. Louis Behavioral Health Services, LLC
- St. Louis Children'S Surgery Center, LLC
All providers in Bridgeton, MO · Durable Medical Equipment & Medical Supplies in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.