Individual provider Active NPI

Tara Rognan, D.O.

  • Family Medicine Physician
  • Lake St Louis, MO
National Provider Identifier
1598147886
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2015019358 Issued in MO
Practice address
400 Medical PLZ Ste 200
Lake St Louis, MO 63367-1417
Phone
(636) 625-2662
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2015019358 MO Primary

Addresses

Primary practice location

400 Medical PLZ Ste 200
Lake St Louis, MO 63367-1417

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 966-9491

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address trognan166042@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824001407 MO Practitioner - Family Practice 4789989740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

400 Medical PLZ
Suite 200
Lake St Louis, MO 63367-1417
Phone (636) 625-2662

Hospital & facility affiliations

  • SSM Health at Home Home Health-St. Louis Home health agency, Saint Louis, MO, CCN 267184
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St Louis CurrentSince Apr 2, 2020 Accepting new patients
SSM Health Care St. Louis CurrentSince Apr 2, 2020 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

400 Medical Plz
Ste 200
Lake St Louis, MO 63367
Phone (636) 625-2662

2022 Dorsett Vlg
Maryland Heights, MO 63043
Phone (314) 520-0520

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

3878 Pershall Rd
Saint Louis, MO 63135
Phone (314) 344-6021

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

Interoperability endpoints

  • Direct secure messaging: trognan166042@direct-ehr-ssmhc.com

Organizations & group practices 5

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 5

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1598147886",
    "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": "400 MEDICAL PLZ STE 200",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671417",
            "telephone_number": "636-625-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2345 Dougherty Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631223313",
            "country_code": "US",
            "telephone_number": "314-966-9491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGNAN",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015019358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trognan166042@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "trognan166042@direct-ehr-ssmhc.com",
            "address_1": "400 Medical Plz Ste 200",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671417",
            "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": "400 Medical Plz Ste 200",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.