JACK MICHAEL SANSONE MD
NPI 1366280414
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Q: What is Jack Sansone's NPI number?

The NPI number for Jack Sansone is 1366280414. It was assigned to this individual provider in the NPPES registry on July 15, 2024.

Q: What is Jack Sansone's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Sansone was last updated on June 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 15, 2024PECOS Enrolled

1201 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 257-8000 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 18, 2025, Jul 15, 2024 (2 updates tracked since 2024).

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About Jack Michael Sansone Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK MICHAEL SANSONE MD (NPI 1366280414) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366280414

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK MICHAEL SANSONECredential: MD

Location Address1201 S GRAND BLVDSaint Louis, MO 63104-1016

Mailing Address1008 S Spring AveSaint Louis, MO 63110-2520 · (314) 617-3237 · Fax (314) 617-3520

Phone(314) 257-8000

Sole ProprietorYes

Enumeration DateJuly 15, 2024

Last NPPES UpdateJune 18, 20252 updates tracked since enumeration

NPPES CertifiedJune 18, 2025

✔ NPI 1366280414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1201 S GRAND BLVD, Saint Louis, MO 63104

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Michael Sansone Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.