NPIMap

Individual provider Active NPI

Erik P Thyssen, MD

  • Gastroenterology Physician
  • Creve Coeur, MO
National Provider Identifier
1750495099
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MDR3P63 Issued in MO
Practice address
Specialists in Gastroenterology
11525 Olde Cabin Road
Creve Coeur, MO 63141
Phone
(314) 997-0554
Fax
(314) 997-5086
NPI assigned
Aug 17, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 MDR3P63 MO Primary

Addresses

Primary practice location

Specialists in Gastroenterology
11525 Olde Cabin Road
Creve Coeur, MO 63141

Mailing address

11525 Olde Cabin Rd
Creve Coeur, MO 63141-7146
Phone (314) 997-0554

Other identifiers 8

IdentifierTypeStateIssuer
003012657OtherMOMEDICARE LEGACY
107244OtherBLUE CROSS/BLUE SHIELD
203703103MedicaidMO
211593OtherHEALTHLINK
4288200OtherAETNA
1059638OtherUHC
43076OtherGHP
100008440OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000556 MO Practitioner - Gastroenterology 9133176019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Health Specialists LLCGroup PAC ID 9739494832, 69 clinicians

Practice addresses (Care Compare)

11525 Olde Cabin Rd
Suite 101
Creve Coeur, MO 63141-7146
Phone (314) 400-9999

3800 S Whitney Ave
Independence, MO 64055-6739
Phone (816) 478-4887

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy208
Upper gastrointestinal (GI) endoscopy for acid reflux169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR3P63MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Specialists, LLC Gastroenterology CurrentSince Jul 10, 2023 Accepting new patients
Bi-State Medical Consultants, Inc. Past Accepting new patients
Advanced Endoscopy Center LLC PastSince Oct 9, 2003 Accepting new patients

Locations

3800 S Whitney Ave
Ste 100
Independence, MO 64055

Interoperability endpoints

  • Direct secure messaging: erik.thyssen.p1@direct.sig.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1750495099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 OLDE CABIN RD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417146",
            "telephone_number": "314-997-0554",
            "fax_number": "314-997-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SPECIALISTS IN GASTROENTEROLOGY",
            "address_2": "11525 OLDE CABIN ROAD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-997-0554",
            "fax_number": "314-997-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THYSSEN",
        "first_name": "ERIK",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "MDR3P63",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY",
            "identifier": "003012657",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "107244",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203703103",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "211593",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4288200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1059638",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "43076",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100008440",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.