Individual provider Active NPI

Emily M Massaro, P.A.

  • Surgical Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1770765950
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2007033181 Issued in MO
Practice address
1465 S Grand Blvd
Department of Orthopedic Surgery
Saint Louis, MO 63104-1003
Phone
(314) 577-5646
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2007033181 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Department of Orthopedic Surgery
Saint Louis, MO 63104-1003

Mailing address

1465 S Grand Blvd Dept of
Saint Louis, MO 63104-1003
Phone (314) 577-5646

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address emassaro8935@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 IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120814000571 IL Practitioner - Physician Assistant 7315193984 Reassigns benefits to 1 organization
I20190308000958 MO Practitioner - Physician Assistant 7315193984 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2007033181MOMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Childrens Hospital CurrentSince Jan 1, 2018 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

400 Medical Plz
Ste 220
Lake St Louis, MO 63367
Phone (314) 577-5674

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

3518 Laclede Ave
Saint Louis, MO 63103
Phone (314) 977-2323

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

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

13000 Butler Crest Dr
Saint Louis, MO 63128
Phone (314) 842-3535

Interoperability endpoints

  • Direct secure messaging: emassaro8935@direct-ehr-ssmhc.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1770765950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD DEPT OF",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "address_2": "DEPARTMENT OF ORTHOPEDIC SURGERY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARO",
        "first_name": "EMILY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2007033181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emassaro8935@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "emassaro8935@direct-ehr-ssmhc.com",
            "address_1": "1465 S Grand Blvd",
            "address_2": "Department of Orthopedic Surgery",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "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": "1465 S Grand Blvd",
            "address_2": "Department of Orthopedic Surgery",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.