Individual provider Active NPI

Anthony Mark Masi, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Ballwin, MO
National Provider Identifier
1902884844
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
R3P21 Issued in MO
Practice address
13975 Manchester Rd
Suite 7
Ballwin, MO 63011-4500
Phone
(636) 391-1222
Fax
(636) 333-1259
NPI assigned
Dec 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X R3P21 MO
Sleep Medicine (Internal Medicine) Physician 207RS0012X R3P21 MO Primary

Addresses

Primary practice location

13975 Manchester Rd
Suite 7
Ballwin, MO 63011-4500

Mailing address

13975 Manchester Rd
Suite 7
Ballwin, MO 63011-4500
Phone (636) 391-1222

Other identifiers 2

IdentifierTypeStateIssuer
203472246MedicaidMO
290015378OtherMORAILROAD MEDICARE

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
I20100602000819 MO Practitioner - Sleep MedicinePractitioner - Pulmonary DiseasePractitioner - Other (Physician) 5799789582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Pulmonary Disease
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13975 Manchester Rd
Suite 7
Manchester, MO 63011-4500
Phone (636) 391-1222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3P21MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Sleep Diagnostics, Inc. CurrentSince Jun 28, 1999 Accepting new patients
Ozarks Medical Center Past Accepting new patients
SSM Health Care St. Louis Pulmonary Disease Past Accepting new patients
Susan Masi Counseling Solutions, LLC PastSince Oct 1, 2002 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1135987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1902884844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13975 MANCHESTER RD",
            "address_2": "SUITE 7",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114500",
            "telephone_number": "636-391-1222",
            "fax_number": "636-333-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13975 MANCHESTER RD",
            "address_2": "SUITE 7",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114500",
            "telephone_number": "636-391-1222",
            "fax_number": "636-333-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASI",
        "first_name": "ANTHONY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-31",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R3P21",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MO",
            "license": "R3P21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203472246",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290015378",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.