Individual provider Active NPI

Rachael Anne Ryan, MD

  • Hospitalist Physician
  • Saint Louis, MO
National Provider Identifier
1669032991
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2022012334 Issued in MO
Practice address
1 Childrens PL
Div Ped Hospitalist Med
Saint Louis, MO 63110-1002
Phone
(314) 454-2076
Fax
(314) 747-8953
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2022012334 MO
Hospitalist Physician 208M00000X 2022012334 MO Primary

Addresses

Primary practice location

1 Childrens PL
Div Ped Hospitalist Med
Saint Louis, MO 63110-1002

Mailing address

PO Box 60352
Saint Louis, MO 63160-0352
Phone (314) 454-2076

Other identifiers 1

IdentifierTypeStateIssuer
200112025MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221114001172 MO Practitioner - Pediatric MedicinePractitioner - Emergency MedicinePractitioner - Hospitalist 5395112866 Reassigns benefits to 2 organizations
I20221205002403 IL Practitioner - Pediatric Medicine 5395112866 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022012334MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc. CurrentSince Aug 24, 2022 Accepting new patients
SSM Health Care Group Pediatrics CurrentSince Mar 1, 2024 Accepting new patients
Washington University CurrentSince Aug 11, 2022 Accepting new patients
SSM Health Care Group CurrentSince Mar 1, 2024 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Aug 24, 2022 Accepting new patients
Washington University CurrentSince Aug 11, 2022 Accepting new patients
SSM Cardinal Glennon Children'S Hospital Past Accepting new patients

Locations

1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

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

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

1234 S Kingshighway Blvd
Ste 1200
Saint Louis, MO 63110

Organizations & group practices 8

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1669032991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60352",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631600352",
            "telephone_number": "314-454-2076",
            "fax_number": "314-747-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED HOSPITALIST MED",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-2076",
            "fax_number": "314-747-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "RACHAEL",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2022012334",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2022012334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200112025",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Hospitalist Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.