Individual provider Active NPI

Angela M Passanise, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Wentzville, MO
National Provider Identifier
1730384413
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
2013018503 Issued in MO
Practice address
801 Medical Dr Ste 400
Wentzville, MO 63385-3824
Phone
(636) 332-8455
NPI assigned
Jun 20, 2007
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 34.010491 OH
Orthopaedic Surgery Physician 207X00000X 03478 KY
Orthopaedic Surgery Physician 207X00000X DO178709 OR
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X DO178709 OR
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 2013018503 MO Primary

Addresses

Primary practice location

801 Medical Dr Ste 400
Wentzville, MO 63385-3824

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address apassanise513880@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
I20131112002135 MO Practitioner - Orthopedic Surgery 9830325216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Kansas City University of Physicians and Surgeons, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

7212 Balson Ave
Saint Louis, MO 63130-3001

801 Medical Dr
Suite 400
Wentzville, MO 63385-3824
Phone (636) 332-8455

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03478KYMDOrthopaedic Surgery Physician
34.010491OHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Aug 12, 2024 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 12, 2024 Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
Franklin County Surgical Associates Inc Past Accepting new patients

Locations

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

801 Medical Dr
Ste 400
Wentzville, MO 63385
Phone (636) 327-3100

Interoperability endpoints

  • Direct secure messaging: apassanise362393@directc.mercy.net
  • Direct secure messaging: apassanise513880@direct-ehr-ssmhc.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1730384413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE 400",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853824",
            "telephone_number": "636-332-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3680 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-754-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASSANISE",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "34.010491",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "03478",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "DO178709",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OR",
            "license": "DO178709",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2013018503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apassanise513880@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "apassanise513880@direct-ehr-ssmhc.com",
            "address_1": "801 Medical Dr Ste 400",
            "city": "Wentzville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633853824",
            "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": "801 Medical Dr Ste 400",
            "city": "Wentzville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633853824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

Verify at the official NPI Registry.