Individual provider Active NPI

Ryan Joseph Terstriep, PT, D.P.T.

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1548867583
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2020017765 Issued in MO
Practice address
12639 Old Tesson Rd Ste 120
Saint Louis, MO 63128-2786
Phone
(314) 849-0311
NPI assigned
Oct 2, 2020
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2020017765 MO Primary

Addresses

Primary practice location

12639 Old Tesson Rd Ste 120
Saint Louis, MO 63128-2786

Mailing address

12639 Old Tesson Rd Ste 120
Saint Louis, MO 63128-2786

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ryan.terstriep@direct.signature.nextgenshare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201012000156 MO Practitioner - Physical Therapist in Private Practice 7012337108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians

Practice addresses (Care Compare)

12639 Old Tesson Rd
Suite 115
Saint Louis, MO 63128-2786
Phone 31484903112384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020017765MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Medical Group, Inc CurrentSince Oct 19, 2020 Accepting new patients
Signature Medical Group, Inc CurrentSince Oct 19, 2020 Accepting new patients

Locations

12639 Old Tesson Rd
Ste 115
Saint Louis, MO 63128
Phone (314) 842-8655

12639 Old Tesson Rd
Ste 120
Saint Louis, MO 63128
Phone (314) 842-3968

Interoperability endpoints

  • Direct secure messaging: ryan.terstriep@direct.signature.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1548867583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERSTRIEP",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "credential": "PT, D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-02",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020017765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ryan.terstriep@direct.signature.nextgenshare.com",
            "affiliation": "N",
            "address_1": "12639 Old Tesson Rd Ste 120",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631282786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.