Individual provider Active NPI

Cynthia Marie Emily, PA

  • Physician Assistant
  • Belleville, IL
National Provider Identifier
1609022417
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003840 Issued in IL
Practice address
211 S 3Rd St
Belleville, IL 62220-1915
Phone
(618) 234-2120
Fax
(618) 641-5806
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2009020443 MO
Physician Assistant 363A00000X 085003840 IL Primary

Addresses

Primary practice location

211 S 3Rd St
Belleville, IL 62220-1915

Mailing address

211 S 3Rd St
Belleville, IL 62220-1915
Phone (618) 234-2120

Other names 1

  • Cyhtnia Marie Eldridge Former name

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
I20090813000491 MO Practitioner - Physician Assistant 6901974062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
I.2405988OHMDClinical Social Worker
2009020443MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Apr 1, 2023 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
RHG of Arizona, PC PastSince Dec 23, 2024 Accepting new patients
BC Missouri Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
North County Emergency Physicians, LLP Emergency Medicine Past Accepting new patients

Locations

1225 S Grand Blvd
#45
Saint Louis, MO 63104

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: cemily450137@direct-ehr-ssmhc.com

Organizations & group practices 6

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1609022417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMILY",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2009020443",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYHTNIA",
            "last_name": "ELDRIDGE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.