NPIMap

Individual provider Active NPI

Patrick J Rose, M.D.

  • Family Medicine Physician
  • Saint Clair, MO
National Provider Identifier
1811208341
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2010019797 Issued in MO
Practice address
1001 Cardwell St
Saint Clair, MO 63077-1094
Phone
(636) 629-3300
Fax
(636) 629-7377
NPI assigned
Jun 30, 2010
Last updated
Jul 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2010019797 MO Primary

Addresses

Primary practice location

1001 Cardwell St
Saint Clair, MO 63077-1094

Mailing address

1001 Cardwell St
Saint Clair, MO 63077-1094
Phone (636) 629-3300

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
I20130830000531 MO Practitioner - Family Practice 6709029259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

1001 Cardwell St
Saint Clair, MO 63077-1094
Phone (636) 629-3300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010019797MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine Current Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jul 1, 2013 Accepting new patients

Locations

1001 Cardwell St
Saint Clair, MO 63077
Phone (636) 390-1684

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Interoperability endpoints

  • Direct secure messaging: prose114757@directc.mercy.net

Organizations & group practices 2

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 9

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1811208341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CARDWELL ST",
            "city": "SAINT CLAIR",
            "state": "MO",
            "postal_code": "630771094",
            "telephone_number": "636-629-3300",
            "fax_number": "636-629-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CARDWELL ST",
            "city": "SAINT CLAIR",
            "state": "MO",
            "postal_code": "630771094",
            "telephone_number": "636-629-3300",
            "fax_number": "636-629-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2010019797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair, MO

Sources for this page

Verify at the official NPI Registry.