NPIMap

Individual provider Active NPI

Natalie D Menossi, PA

  • Physician Assistant
  • Glen Carbon, IL
National Provider Identifier
1912195447
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-002316 Issued in IL
Practice address
4230 S State Route 159
Glen Carbon, IL 62034-3201
Phone
(618) 391-9443
Fax
(618) 391-9449
NPI assigned
Oct 10, 2007
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-002316 IL Primary

Addresses

Primary practice location

4230 S State Route 159
Glen Carbon, IL 62034-3201

Mailing address

4230 S State Route 159
Glen Carbon, IL 62034-3201
Phone (618) 391-9443

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address natalie.menossi.1@9559.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20080703000046 IL Practitioner - Physician Assistant 5799857975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 State St
East Saint Louis, IL 62205-1803
Phone (618) 271-9191

4230 S State Route 159
Glen Carbon, IL 62034-3201
Phone (618) 391-9443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-002316ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation, Inc. CurrentSince Jun 21, 2024 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Jun 21, 2024 Accepting new patients
Southern Illinois Healthcare Foundation Inc Past Accepting new patients

Locations

1215 Vandalia St
Collinsville, IL 62234
Phone (618) 343-6015

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

4230 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-6870

2041 Goose Lake Rd
Sauget, IL 62206

Interoperability endpoints

  • Direct secure messaging: natalie.menossi.1@9559.direct.athenahealth.com
  • Direct secure messaging: nmenossi@yourcarecommunity.org

Organizations & group practices 3

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 7

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": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1912195447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343201",
            "telephone_number": "618-391-9443",
            "fax_number": "618-391-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343201",
            "telephone_number": "618-391-9443",
            "fax_number": "618-391-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENOSSI",
        "first_name": "NATALIE",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "natalie.menossi.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1215 Vandalia St",
            "city": "Collinsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622344060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

Verify at the official NPI Registry.