Individual provider Active NPI

Amy Jo Gable, PA

  • Surgical Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1912175969
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2010017122 Issued in MO
Practice address
555 N New Ballas Rd
Div Surg Vascular, Ste 265
Saint Louis, MO 63141-6825
Phone
(314) 991-4644
Fax
(866) 342-0133
NPI assigned
Feb 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2010017122 MO Primary

Addresses

Primary practice location

555 N New Ballas Rd
Div Surg Vascular, Ste 265
Saint Louis, MO 63141-6825

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 991-4644

Other identifiers 1

IdentifierTypeStateIssuer
220053052MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100816000800 MO Practitioner - Physician Assistant 6204906977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 273-7373

1 Barnes Jewish Hospital PLZ
Suite 200
Saint Louis, MO 63110-1003
Phone (314) 273-7373

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Mar 1, 2023 Accepting new patients
Washington University CurrentSince Mar 1, 2023 Accepting new patients
Washington University Past Accepting new patients
Suburban Surgical Associates, Inc. Past Accepting new patients

Locations

660 S Euclid Ave
Saint Louis, MO 63110

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

555 N New Ballas Rd
Ste 265
Saint Louis, MO 63141
Phone (314) 991-4644

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": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1912175969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-991-4644",
            "fax_number": "866-342-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N NEW BALLAS RD",
            "address_2": "DIV SURG VASCULAR, STE 265",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416825",
            "telephone_number": "314-991-4644",
            "fax_number": "866-342-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABLE",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2025-04-17",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2010017122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220053052",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "555 N New Ballas Rd",
            "address_2": "Div Surg Vascular, Ste 265",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.