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SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA
NPI 1477097871
Anesthesiology in Centralia, IL

Active since December 05, 2016
400 N PLEASANT AVE, CENTRALIA, IL 62801(618) 436-6056(618) 532-9365 Get Directions Write a Review

NPPES record last updated: March 26, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ssm Health St. Mary's Hospital - Centralia NPPES

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

SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA (NPI 1477097871) is a healthcare organization registered as an anesthesiology in Centralia, Illinois and active in the NPI registry since December 2016. The organization lists Tim Buller, Regional Cfo, as its authorized official.

NPPES Registry Identity

NPI1477097871
Entity TypeOrganization
Primary Taxonomy207L00000X
Legal Business NameST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Location Address400 N PLEASANT AVECentralia, IL 62801-3056
Mailing Address1145 Corporate Lake DrSaint Louis, MO 63132-2907 · (314) 989-2492 · Fax (314) 344-7281
Phone(618) 436-6056
Fax(618) 532-9365
Organization SubpartNo
Authorized OfficialTim BullerRegional Cfo · (314) 989-2492
Enumeration DateDecember 5, 2016
Last NPPES UpdateMarch 26, 2018
✔ NPI 1477097871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in IL · 0002642
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X · License 0002642 (IL)
400 N PLEASANT AVE, Centralia, IL 62801
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Other Names 1

Doing Business AsSsm Health St. Mary's Hospital - Centralia

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ssm Health St. Mary's Hospital - Centralia is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

389

Medicare enrollment records show 389 clinicians reassign Medicare billing to Ssm Health St. Mary's Hospital - Centralia, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 30

Diagnostic Radiology102
Psychiatry50
Certified Registered Nurse Anesthetist (CRNA)42
Nurse Practitioner38
Internal Medicine35
Hospitalist23
Anesthesiology17
General Surgery12
22 other specialties70

Nearest to this location (20)

See all 389
Emily Alli, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1932161817
400 N PLEASANT AVE
Centralia, IL 62801
(618) 436-6204
✔ PECOS✔ Accepts MedicareSame address
Lyle Pahnke, MD
General Surgery
NPI 1770538225
400 N PLEASANT AVE
Centralia, IL 62801
(618) 436-6318
✔ PECOS✔ Accepts MedicareSame address
Jana Tull, APN
Nurse Practitioner
NPI 1588105654
400 N PLEASANT AVE
Centralia, IL 62801
(618) 436-8000
✔ PECOS✔ Accepts MedicareSame address
Alicia Yaeger, FNP, PMHNP, FPA
Nurse Practitioner
NPI 1861911026
400 N PLEASANT AVE
Centralia, IL 62801
(618) 436-8000
✔ PECOS✔ Accepts MedicareSame address
Stacy Menees, FNP
Nurse Practitioner
NPI 1386815959
432 N PLEASANT AVE
Centralia, IL 62801
(618) 436-8300
✔ PECOSSame address
Andrea Johnson, PMHNP
Nurse Practitioner
NPI 1316610256
444 N PLEASANT AVE
Centralia, IL 62801
(618) 436-5665
✔ PECOS✔ Accepts MedicareSame address
Sharon Reed, LCPC
Mental Health Counselor
NPI 1285733386
444 N PLEASANT AVE
Centralia, IL 62801
(618) 436-8000
✔ PECOS✔ Accepts MedicareSame address
Amber Wennerstrom, DNP, PMHNP-C
Nurse Practitioner
NPI 1144844572
444 N PLEASANT AVE
Centralia, IL 62801
(618) 436-5665
✔ PECOS✔ Accepts MedicareSame address
Deborah Murphy, R.N., APRN, PMHNP-BC
Nurse Practitioner
NPI 1376074377
400 N PLEASANT AVE
Centralia, IL 62801
(618) 346-8000
✔ PECOS✔ Accepts Medicare0.4 mi
Melissa Karaffa, APN
Nurse Practitioner
NPI 1356629612
444 N PLEASANT AVE
Centralia, IL 62801
(618) 436-5665
✔ PECOS✔ Accepts Medicare0.5 mi
Maamoun Junidi, MD
General Surgery
NPI 1366488660
803 E BROADWAY
Centralia, IL 62801
(618) 532-4511
✔ PECOS0.5 mi
Stephen Ang, MD
Gastroenterology
NPI 1346251071
1054 M L KING DR SUITE 120
Centralia, IL 62801
(618) 532-1688
✔ PECOS✔ Accepts Medicare0.9 mi
Merrilee Brandt, M.D.
General Surgery
NPI 1942243811
1054 MARTIN LUTHER KING DR SUITE 125
Centralia, IL 62801
(618) 436-5200
✔ PECOS✔ Accepts Medicare0.9 mi
Melissa Dane, M.A.
Mental Health Counselor
NPI 1215331509
904 E MARTIN LUTHER KING DR.
Centralia, IL 62801
(618) 533-1391
✔ PECOS✔ Accepts Medicare0.9 mi
Stacey Dinkelman
Mental Health Counselor
NPI 1417328741
904 E MARTIN LUTHER KING DR.
Centralia, IL 62801
(618) 533-1391
✔ PECOS✔ Accepts Medicare0.9 mi
Naeem Khan, MD
Cardiovascular Disease (Cardiology)
NPI 1942229810
1050 MARTIN LUTHER KING DRIVE STE #108
Centralia, IL 62801
(618) 532-8574
✔ PECOS✔ Accepts Medicare0.9 mi
Janet Merrell, MSN, APN, CNS, BC
Certified Clinical Nurse Specialist (CNS)
NPI 1447222419
904 M L KING DR
Centralia, IL 62801
(618) 533-1391
✔ PECOS✔ Accepts Medicare0.9 mi
Aziz Rahman, MD
Pulmonary Disease
NPI 1275540015
1050 M L KING DR SUITE 109
Centralia, IL 62801
(618) 532-0998
✔ PECOS✔ Accepts Medicare0.9 mi
James Schutzenhofer, MD
Internal Medicine
NPI 1851392229
1050 MARTIN LUTHER KING DRIVE
Centralia, IL 62801
(618) 545-1705
✔ PECOS✔ Accepts Medicare0.9 mi
Syed Shah, M.D.
Neurology
NPI 1508867300
1007 ML KING DR SUITE 1
Centralia, IL 62801
(618) 533-9577
✔ PECOS✔ Accepts Medicare0.9 mi
See all 389 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Mary's Hospital, Centralia, Illinois's NPI number?

The NPI number for St. Mary's Hospital, Centralia, Illinois is 1477097871. It was assigned to this organization in the NPPES registry on December 5, 2016. The provider is doing business as Ssm Health St. Mary's Hospital - Centralia.

Where is St. Mary's Hospital, Centralia, Illinois located?

St. Mary's Hospital, Centralia, Illinois is located at 400 N Pleasant Ave, Centralia, IL 62801. The listed phone number is (618) 436-6056.

What is St. Mary's Hospital, Centralia, Illinois's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is St. Mary's Hospital, Centralia, Illinois enrolled in Medicare?

Yes. St. Mary's Hospital, Centralia, Illinois is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St. Mary's Hospital, Centralia, Illinois?

According to the CMS Revalidation Reassignment List (October 2026 release), 389 clinicians in 30 Medicare specialties reassign their Medicare billing to St. Mary's Hospital, Centralia, Illinois. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (102), Psychiatry (50) and Certified Registered Nurse Anesthetist (CRNA) (42). Of these, 8 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for St. Mary's Hospital, Centralia, Illinois was last updated on March 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.