Individual provider Active NPI

Josie Marie Zuckerman, PA-C

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1679674964
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102583 Issued in MO
Practice address
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone
(314) 353-5190
Fax
(314) 353-7631
NPI assigned
Sep 26, 2006
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102583 MO Primary

Addresses

Primary practice location

401 Holly Hills Ave
Saint Louis, MO 63111-2410

Mailing address

3824 S Grand Blvd
Saint Louis, MO 63118-3412
Phone (314) 814-8180

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
I20120519000043 MO Practitioner - Physician Assistant 9234392796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1225 Graham Rd
Suite 1220B
Florissant, MO 63031-8012
Phone (314) 953-8250

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102583MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Health Centers CurrentSince Sep 14, 2026 Accepting new patients
Family Care Health Centers CurrentSince Sep 14, 2026 Accepting new patients

Locations

401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190

4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336

Interoperability endpoints

  • Direct secure messaging: josie.zuckerman.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1679674964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183412",
            "telephone_number": "314-814-8180",
            "fax_number": "314-814-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-353-5190",
            "fax_number": "314-353-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKERMAN",
        "first_name": "JOSIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "102583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.