Matthew H Nissing, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

2002007106 Issued in MO

Practice address

915 N Grand Blvd
Saint Louis, MO 63106-1621

Phone

(314) 289-6434

NPI assigned

Apr 10, 2006

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mnissing134881@direct.carenet.org

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1558324418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BJC SAINT PETERS DR",
            "address_2": "SUITE 100",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763091",
            "telephone_number": "636-916-8200",
            "fax_number": "636-926-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-289-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSING",
        "first_name": "MATTHEW",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2002007106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200603702",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard James Nissen, DDS, MS
• Stephanie D Nissen, RN, ACNP-BC
• Andrea Nissenbaum
• Arthur H Nissenbaum, LPC
• Sylvia Nissenboim, LCSW
• Gary G Nitz, CRNA
• Austin Jiazhi Niu, MD
• Olivia Louise Nixon-Hemelt, MD
• Jameshia Quianna Nixon
• Melissa Ellen Nixon, NP

• Gastroenterology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.