Active NPI
Mark D Saxon, P.A.
- Surgical Physician Assistant
- Chesterfield, MO
National Provider Identifier
1821060161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 2003011041
- Practice address
- 15740 S Outer 40 Rd
Chesterfield, MO 63017-2004 - Phone
- (636) 735-4205
- Fax
- (314) 251-1053
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 2003011041 | MO | Primary |
Addresses
Primary practice location
15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Mailing address
15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 735-4205
Other practice location 1
625 S New Ballas Rd
Suite R-7040
Saint Louis, MO 63141-8232
Phone (314) 521-6970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00666812 | Other | MO | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003011041 | MO | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Cardiovascular and Thoracic Surgery, LLC | Past | Accepting new patients |
Interoperability endpoints
- msaxon1339@directc.mercy.net
Organizations & group practices 1
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.
-
- Vascular Surgery Physician
- Washington, MO
- NPI 1528192416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1821060161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15740 S OUTER 40 RD",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630172004",
"telephone_number": "636-735-4205",
"fax_number": "314-251-1053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15740 S OUTER 40 RD",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630172004",
"telephone_number": "636-735-4205",
"fax_number": "314-251-1053"
}
],
"practiceLocations": [
{
"address_1": "625 S New Ballas Rd",
"address_2": "Suite R-7040",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631418232",
"country_code": "US",
"telephone_number": "314-521-6970",
"fax_number": "314-251-1053",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAXON",
"first_name": "MARK",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MO",
"license": "2003011041",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00666812",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chesterfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.