Individual provider Active NPI

Benjamin Zimmerman Root, M.D.

  • Gastroenterology Physician
  • Saint Louis, MO
National Provider Identifier
1619355765
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2021008458 Issued in MO
Practice address
11525 Olde Cabin Rd
Saint Louis, MO 63141-7146
Phone
(314) 279-9049
Fax
(314) 997-5086
NPI assigned
May 9, 2015
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Gastroenterology Physician 207RG0100X 2021008458 MO Primary

Addresses

Primary practice location

11525 Olde Cabin Rd
Saint Louis, MO 63141-7146

Mailing address

11525 Olde Cabin Rd
Saint Louis, MO 63141-7146

Other practice location 1

550 1st Ave
NYU Langone Medical Center
New York, NY 10016-6402
Phone (212) 263-5506

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
I20210518000787 MO Practitioner - Gastroenterology 2860801149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Jefferson Medical College of Thomas Jefferson University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Health Specialists LLCGroup PAC ID 9739494832, 69 clinicians

Practice addresses (Care Compare)

11525 Olde Cabin Rd
Suite 101
Creve Coeur, MO 63141-7146
Phone (314) 400-9999

3800 S Whitney Ave
Independence, MO 64055-6739
Phone (816) 478-4887

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy153
Upper gastrointestinal (GI) endoscopy for acid reflux145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021008458MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Specialists, LLC Gastroenterology CurrentSince Jul 10, 2023 Accepting new patients

Locations

3800 S Whitney Ave
Ste 100
Independence, MO 64055

11525 Olde Cabin Rd
Ste 101
Saint Louis, MO 63141
Phone (314) 400-9999

Interoperability endpoints

  • Direct secure messaging: benjamin.root.p1@direct.sig.nextgenshare.com

Organizations & group practices 1

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.

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": "1431129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1619355765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 OLDE CABIN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 OLDE CABIN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417146",
            "telephone_number": "314-279-9049",
            "fax_number": "314-997-5086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_2": "NYU Langone Medical Center",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOT",
        "first_name": "BENJAMIN",
        "middle_name": "ZIMMERMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-09",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2021008458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.