Individual provider Active NPI

Bryar A Bequette, PA-C

  • Medical Physician Assistant
  • Washington, MO
National Provider Identifier
1972161206
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2019017143 Issued in MO
Practice address
901 Patients First Dr Ste 2000
Washington, MO 63090-4700
Phone
(636) 390-1684
Fax
(636) 231-3644
NPI assigned
Jun 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2019017143 MO Primary

Addresses

Primary practice location

901 Patients First Dr Ste 2000
Washington, MO 63090-4700

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (636) 390-1684

Other practice location 1

452 Sovereign Ct
Ballwin, MO 63011-4447
Phone (314) 238-6527

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
I20191014003656 MO Practitioner - Physician Assistant 4587995048 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Jan 9, 2025 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 5, 2025 Accepting new patients
Mercy Clinic East Communities CurrentSince Feb 19, 2024 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jan 9, 2025 Accepting new patients
Mercy Clinic East Communities CurrentSince Feb 19, 2024 Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

901 Patients First Dr
Ste 2000
Washington, MO 63090
Phone (636) 239-7344

851 E 5th St
Ste 228
Washington, MO 63090
Phone (636) 239-0018

Organizations & group practices 8

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospitals East Communities 29 clinicians

Practice addresses (Care Compare)

901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8000

Hospital & facility affiliations

  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052

NPI Registry JSON

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

{
    "created_epoch": "1559347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1972161206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "636-390-1684",
            "fax_number": "636-231-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR STE 2000",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-390-1684",
            "fax_number": "636-231-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "452 Sovereign Ct",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630114447",
            "country_code": "US",
            "telephone_number": "314-238-6527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEQUETTE",
        "first_name": "BRYAR",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-01",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2019017143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.