Individual provider Active NPI

Grace Marie Eftink, PA-S

  • Physician Assistant
  • Festus, MO
National Provider Identifier
1699552018
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2024036848 Issued in MO
Practice address
660A S Truman Blvd
Festus, MO 63028-2235
Phone
(362) 068-0496
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 2024036848 MO Primary

Addresses

Primary practice location

660A S Truman Blvd
Festus, MO 63028-2235

Mailing address

660A S Truman Blvd
Festus, MO 63028-2235
Phone (362) 068-0496

Other practice location 1

208 University Dr
West Liberty, WV 26074-1082
Phone (304) 336-5098

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
I20240925000152 MO Practitioner - Physician Assistant 1052852464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

10700 Manchester Rd
Suite E
Kirkwood, MO 63122-1307
Phone (314) 428-9541

1722 Clarkson Rd
Chesterfield, MO 63017-4976
Phone (636) 206-2665

2015 Maplewood Commons Dr
Saint Louis, MO 63143-1003
Phone (314) 293-4023

2031 Zumbehl Rd
Saint Charles, MO 63303-2723
Phone (636) 206-2690

409 Lafayette Ctr
Manchester, MO 63011-3943
Phone (636) 707-0764

5640 C Telegraph Rd
Saint Louis, MO 63129-4243
Phone (314) 293-4413

660 A S Truman Blvd
Festus, MO 63028-2235
Phone (636) 206-8049

676 Gravois Bluffs Blvd
Suite A1
Fenton, MO 63026-7742
Phone (636) 492-2245

9551 Watson Rd
Mercy Gohealth Crestwood
Saint Louis, MO 63126-1532
Phone (314) 501-1826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024036848MOMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1699552018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660A S TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282235",
            "telephone_number": "362-068-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660A S TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282235",
            "telephone_number": "362-068-0496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 University Dr",
            "address_purpose": "LOCATION",
            "city": "West Liberty",
            "state": "WV",
            "postal_code": "260741082",
            "country_code": "US",
            "telephone_number": "304-336-5098",
            "fax_number": "304-336-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EFTINK",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2024036848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.