Dustin Jamboretz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1000 Des Peres Rd Ste 210
Saint Louis, MO 63131-2062

Phone

(314) 896-4263

NPI assigned

Apr 11, 2016

Last updated

Jan 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SBKT Enterprises, LLCGroup PAC ID 9638482961, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• SBKT Enterprises, LLC

  • Orthopaedic Hand Surgery Physician
  • Saint Louis, MO
  • NPI 1932599354
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  dba SSM Health St. Clare Hospital - Fenton

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1720442387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 NE 74TH PL",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581269",
            "telephone_number": "816-668-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DES PERES RD STE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312062",
            "telephone_number": "314-896-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMBORETZ",
        "first_name": "DUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdi Jama
• Mahamed Jama
• Mekeya Jama, LCSW
• Ali Ayman Jamal, M.D.
• Nida Jamal, M.D.
• Charryse Jamerson
• Kristine Szorady Jamerson, R.D., L.D.
• Victoria Jamerson
• James a Anderson, a Sole Proprietor (Vital Care of St. Louis)
• James C. Bobrow, Inc.

• Physician Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.