Susan Michelle Wittlich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

111398 Issued in MO

Practice address

14 Village Square Shop Ctr
Hazelwood, MO 63042-1818

Phone

(636) 253-0493

NPI assigned

Jun 8, 2011

Last updated

May 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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.

• St Louis Pain Consultants LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Chesterfield, MO
  • NPI 1558611426
  Medicare reassignment

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1750675526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 MIRASOL TRL, EUREKA, MO 63025",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "63025",
            "telephone_number": "636-253-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VILLAGE SQUARE SHOP CTR",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421818",
            "telephone_number": "636-253-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11144 Tesson Ferry Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631236965",
            "country_code": "US",
            "telephone_number": "636-253-0493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2163 W Terra Ln",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633662366",
            "country_code": "US",
            "telephone_number": "636-253-0493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTLICH",
        "first_name": "SUSAN",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "111398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanetta Marie Wilkerson, DC
• Kristy T Williams, D.C.
• Monique Marie Williams, MD
• Pamela Wingo, LPN
• With Open Arms Healthcare LLC
• Michael James Wittmer, D.C.
• Olivia Louise Young, NP.
• Faris Mujahed Ziyad, DMD

• Physician Assistant in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.