Individual provider Active NPI

Jody T Jachna, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Saint Charles, MO
National Provider Identifier
1891728051
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
2005015585 Issued in MO
Practice address
400 1St Capitol Dr Ste 100
Saint Charles, MO 63301-2881
Phone
(636) 332-8455
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 2005015585 MO Primary

Addresses

Primary practice location

400 1St Capitol Dr Ste 100
Saint Charles, MO 63301-2881

Mailing address

PO Box 955534
Saint Louis, MO 63195-4426

Other practice location 1

12266 DePaul Dr
110
Bridgeton, MO 63044-2514
Phone (314) 291-7900

Other identifiers 1

IdentifierTypeStateIssuer
207332107MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jjachna11971@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 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

Enrollment IDStateProvider typePAC IDDetails
I20050804000751 MO Practitioner - Orthopedic Surgery 1355311762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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)

400 1St Capitol Dr
Suite 401
Saint Charles, MO 63301-2886
Phone (636) 669-2220

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • SSM Health at Home Home Health-St. Louis Home health agency, Saint Louis, MO, CCN 267184
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement29
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005015585MOMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Northland Orthopedic Group PastSince Sep 1, 2005 Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

400 1st Capitol Dr
Ste 100
Saint Charles, MO 63301
Phone (636) 332-8455

1475 Kisker Rd
Ste 100
Saint Charles, MO 63304
Phone (636) 332-8455

400 1st Capitol Dr
Ste 401
Saint Charles, MO 63301
Phone (314) 946-8700

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1891728051",
    "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": "631954426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 1ST CAPITOL DR STE 100",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012881",
            "telephone_number": "636-332-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12266 DePaul Dr",
            "address_2": "110",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442514",
            "country_code": "US",
            "telephone_number": "314-291-7900",
            "fax_number": "314-291-7914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACHNA",
        "first_name": "JODY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2005015585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207332107",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjachna11971@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jjachna11971@direct-ehr-ssmhc.com",
            "address_1": "400 1st Capitol Dr Ste 100",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633012881",
            "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 1st Capitol Dr Ste 100",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633012881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.