Individual provider Active NPI

Brent A Neuschwander-Tetri, MD

  • Gastroenterology Physician
  • Saint Louis, MO
National Provider Identifier
1699783563
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R3P51 Issued in MO
Practice address
1225 S Grand Blvd FL 3
Saint Louis, MO 63104-1016
Phone
(314) 257-3760
Fax
(314) 257-3761
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X R3P51 MO Primary

Addresses

Primary practice location

1225 S Grand Blvd FL 3
Saint Louis, MO 63104-1016

Mailing address

1008 S Spring Ave
Saint Louis, MO 63110-2520
Phone (314) 977-2140

Other identifiers 1

IdentifierTypeStateIssuer
203018007MedicaidMO

Other names 1

  • Brent A Tetri Professional name

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address btetri3988@direct-ehr-ssmhc.com Direct
Direct Messaging Address btetri3988@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20100514000126 MO Practitioner - GastroenterologyPractitioner - Internal Medicine 8123156932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Yale University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

2315 Dougherty Ferry Rd
Suite 211
Saint Louis, MO 63122-3383
Phone (314) 977-7893

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Upper gastrointestinal (GI) endoscopy for acid reflux19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3P51MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Gastroenterology CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. PastSince Feb 14, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2315 Dougherty Ferry Rd
Ste 211
Saint Louis, MO 63122
Phone (314) 977-7893

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

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

1225 S Grand Blvd
Fl 3
Saint Louis, MO 63104
Phone (314) 257-3760

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

Interoperability endpoints

  • Direct secure messaging: btetri3988@direct-ehr-ssmhc.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1699783563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-2140",
            "fax_number": "314-977-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD FL 3",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-257-3760",
            "fax_number": "314-257-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUSCHWANDER-TETRI",
        "first_name": "BRENT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "R3P51",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203018007",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3660 Vista",
            "city": "St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btetri3988@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "btetri3988@direct-ehr-ssmhc.com",
            "address_1": "3660 Vista",
            "city": "St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btetri3988@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "btetri3988@direct-ehr-ssmhc.com",
            "address_1": "1225 S Grand Blvd Fl 3",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1225 S Grand Blvd Fl 3",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRENT",
            "last_name": "TETRI",
            "middle_name": "A",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.