Active NPI
Irma Mustafic, PA-C
- Physician Assistant
- Bridgeton, MO
National Provider Identifier
1992657530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1243677
- Practice address
- 12303 De Paul Dr
Bridgeton, MO 63044-2512 - Phone
- (314) 344-6000
- NPI assigned
- Feb 13, 2026
- Last updated
- Feb 13, 2026
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1243677 | MO | Primary |
Addresses
Primary practice location
12303 De Paul Dr
Bridgeton, MO 63044-2512
Mailing address
12303 De Paul Dr
Bridgeton, MO 63044-2512
Other practice location 1
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1243677 | MO | MD | Physician Assistant |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770940800000",
"number": "1992657530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12303 DE PAUL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12303 DE PAUL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442512",
"telephone_number": "314-344-6000"
}
],
"practiceLocations": [
{
"address_1": "6420 Clayton Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631171811",
"country_code": "US",
"telephone_number": "314-768-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUSTAFIC",
"first_name": "IRMA",
"name_prefix": "Miss",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-13",
"last_updated": "2026-02-13",
"certification_date": "2026-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "1243677",
"primary": true
}
],
"identifiers": [],
"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 Feb 13, 2026; 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.