Active NPI
Nikita Wagle, MD
- Physical Medicine & Rehabilitation Physician
- Bridgeton, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 2023033486
- Practice address
- 12380 De Paul Dr
Bridgeton, MO 63044-2511 - Phone
- (314) 447-9700
- NPI assigned
- Jun 28, 2019
- Last updated
- Dec 2, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 2023033486 | MO | Primary |
Addresses
Primary practice location
12380 De Paul Dr
Bridgeton, MO 63044-2511
Mailing address
1776 Woodstead CT Ste 208
The Woodlands, TX 77380-1480
Phone (281) 724-3050
Other practice location 1
100 Medical Plz
Lake St Louis, MO 63367-1366
Phone (636) 625-5200
Other practice location 2
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200131311 | Medicaid | MO |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Indiana University School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Medical PLZ
Lake Saint Louis, MO 63367-1366
Phone (636) 625-5200
Hospital & facility affiliations
- SSM St Joseph Hospital West
- SSM Health Depaul Hospital St Louis
- SSM St Joseph Health Center
- SSM Health Saint Louis University Hospital
- SSM Health St Mary's Hospital - St Louis
- SSM Health Rehabilitation Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023033486 | MO | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Post-Acute Physicians of Missouri PC | Physical Medicine & Rehabilitation | Current | Accepting new patients |
| SSM Select Rehab St Louis LLC | Past | Accepting new patients |
Locations
12380 De Paul Dr
Bridgeton, MO 63044
Phone (314) 447-9700
100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200
100 Medical Plz
Fl 5
Lake St Louis, MO 63367
Phone (636) 625-5200
2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050
1027 Bellevue Ave
Saint Louis, MO 63117
Phone (314) 645-6450
1776 Woodstead Ct
Ste 208
The Woodlands, TX 77380
Phone (281) 724-3100
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Bridgeton, MO
- NPI 1164818290
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health Cardinal Glennon Children's Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
dba SSM Health St. Joseph Hospital - St. Charles
- General Acute Care Hospital
- Saint Charles, MO
- NPI 1467521146
-
dba SSM Health DePaul Hospital - St. Louis
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
-
dba SSM Health St Joseph Hospital - Lake Saint Louis
- General Acute Care Hospital
- Lake St Louis, MO
- NPI 1871665380
-
dba SSM Health St. Mary's Hospital - St. Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
Inpatient rehabilitation facility
-
dba SSM Health Saint Louis University Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764633600000",
"number": "1932761095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 WOODSTEAD CT STE 208",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773801480",
"telephone_number": "281-724-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12380 DE PAUL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442511",
"telephone_number": "314-447-9700"
}
],
"practiceLocations": [
{
"address_1": "100 Medical Plz",
"address_purpose": "LOCATION",
"city": "Lake St Louis",
"state": "MO",
"postal_code": "633671366",
"country_code": "US",
"telephone_number": "636-625-5200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6420 Clayton Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631171811",
"country_code": "US",
"telephone_number": "314-768-5200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGLE",
"first_name": "NIKITA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MO",
"license": "2023033486",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200131311",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.