Jason B Vangundy, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2001012077 Issued in MO

Practice address

400 Medical PLZ Ste 200
Lake St Louis, MO 63367-1417

Phone

(636) 625-2662

NPI assigned

Mar 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Bridgeton, MO, CCN 267595
• SSM Health at Home Home Health-St. Louis Home health agency, Saint Louis, MO, CCN 267184
• Centerwell Home Health Home health agency, Creve Coeur, MO, CCN 267290
• Aw Health Care Home health agency, Saint Louis, MO, CCN 267585
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  Medicare reassignment Care Compare group NPD
• Aging Well Health Care, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1215936588
  Care Compare group
• SSM Health Care St. Louis

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Creve Coeur, MO
  • NPI 1215963921
  Care Compare affiliation Name & address match
• SSM Health Businesses

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1609840552
  Care Compare affiliation Name & address match
• Aging Well Health Care, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1215936588
  Care Compare affiliation
• Pyramid Home Health, Inc

  • Home Health Agency
  • Bridgeton, MO
  • NPI 1548207475
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1790746071",
    "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": "400 MEDICAL PLZ STE 200",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671417",
            "telephone_number": "636-625-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Lake St Louis",
            "state": "MO",
            "postal_code": "633671481",
            "country_code": "US",
            "telephone_number": "636-625-2662",
            "fax_number": "636-669-2401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANGUNDY",
        "first_name": "JASON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001012077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvangundy13535@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jvangundy13535@direct-ehr-ssmhc.com",
            "address_1": "400 Medical Plz Ste 200",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671417",
            "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": "400 Medical Plz Ste 200",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Veyo, LLC

• Family Medicine Physician in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.