PAUL A HINTON MD
NPI 1639130263
Internal Medicine in Lake St Louis, MO

Q: What is Paul Hinton's NPI number?

The NPI number for Paul Hinton is 1639130263. It was assigned to this individual provider in the NPPES registry on March 31, 2006.

Q: What is Paul Hinton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Paul Hinton was last updated on May 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 31, 2006PECOS EnrolledAccepts Medicare Assignment

400 MEDICAL PLZ STE 200, LAKE ST LOUIS, MO 63367(636) 625-2662(636) 294-5908 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 21, 2025, Apr 4, 2025 (2 updates tracked since 2025).

On this page

About Paul A Hinton Md NPPES

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

PAUL A HINTON MD (NPI 1639130263) is an individual internal medicine provider in Lake St Louis, Missouri, licensed in Missouri (2006003131) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Ssm St Joseph Health Center, and is a graduate of Saint Louis University School Of Medicine (2002).

NPPES Registry Identity

NPI1639130263

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NamePAUL A HINTONCredential: MD

Location Address400 MEDICAL PLZ STE 200Lake St Louis, MO 63367-1417

Mailing Address1002 Peruque Crossing Ct, Ste 101O Fallon, MO 63366-2362 · (636) 294-5900 · Fax (636) 294-5908

Phone(636) 625-2662

Fax(636) 294-5908

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2002

Enumeration DateMarch 31, 2006

Last NPPES UpdateMay 21, 20252 updates tracked since enumeration

NPPES CertifiedMay 21, 2025

✔ NPI 1639130263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MO · 2006003131

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X · License 2006003131 (MO)

400 MEDICAL PLZ STE 200, Lake St Louis, MO 63367

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Other Identifiers 1

Medicaid200184109MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Paul A Hinton Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739198342

PECOS Enrollment IDI20060410000548

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.

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

523 services306 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

484 services84 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

387 services100 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

285 services192 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

237 services94 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

175 services73 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

105 services87 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

95 services70 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

89 services89 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

85 services28 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

77 services53 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

76 services60 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

60 services29 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

57 services15 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

45 services45 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

41 services40 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

25 services24 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

25 services25 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

25 services25 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

22 services14 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

17 services13 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm St Joseph Health Center

Acute Care Hospitals · Saint Charles, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260005

Location300 1st Capitol DrSaint Charles, MO 63301 · St. Charles County

Emergency services

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number260032

LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County

Emergency services Birthing friendly

Ssm Health Depaul Hospital St Louis

Acute Care Hospitals · Bridgeton, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260104

Location12303 Depaul DriveBridgeton, MO 63044 · St. Louis County

Emergency services Birthing friendly

Missouri Baptist Medical Center

Acute Care Hospitals · Town And Country, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260108

Location3015 N Ballas RdTown And Country, MO 63131 · St. Louis County

Emergency services Birthing friendly

Ssm St Joseph Hospital West

Acute Care Hospitals · Lake Saint Louis, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260200

Location100 Medical PlazaLake Saint Louis, MO 63367 · St. Charles County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63367 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$128.28 typical visit price

range $55.65 – $169.38

Typical copayment $32.07 (range $13.91 – $42.34)

Most-billed visit code 99204

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

65%466 patients3/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

43%7,276 patients1/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

5%772 patients1/55-star benchmark: 99%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

37%772 patients2/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

14%2,697 patients1/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

22%2,156 patients2/55-star benchmark: 88%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 5% · 772 patients

10%772 patients3/55-star benchmark: 100%

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

42%130 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

11 suppliers29 claims90 services$6.62 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

1 supplier13 claims13 services$2.95 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

3 suppliers14 claims20 services$1.23 avg. paid by Medicare

Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4311

DME-Orthotic Devices · category DF000N

1 supplier11 claims11 services$12.17 avg. paid by Medicare

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314

DME-Orthotic Devices · category DF000N

1 supplier12 claims12 services$24.47 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

1 supplier12 claims12 services$9.40 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA M REBORE

Nurse Practitioner (Family)

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

DR. TARA ROGNAN D.O.

Family Medicine

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

KAYLI SCHOU PA-C

Physician Assistant

400 MEDICAL PLZ STE 200
LAKE SAINT LOUIS, MO 63367

St. Charles County (636) 625-2662

AMANDA GARTH NP-C

Nurse Practitioner (Family)

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

DR. BRIAN M SMITH M.D.

Family Medicine

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

DR. JASON B VANGUNDY M.D.

Family Medicine

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

DR. JESSICA ADELLE MILLER M.D.

Family Medicine

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

KAITLYN MARY CAFAZZA APRN, PNP-BC

Nurse Practitioner (Pediatrics)

400 MEDICAL PLZ STE 200
LAKE ST LOUIS, MO 63367

St. Charles County (636) 625-2662

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 Paul Hinton's NPI number?

The NPI number for Paul Hinton is 1639130263. It was assigned to this individual provider in the NPPES registry on March 31, 2006.

Where is Paul Hinton located?

Paul Hinton practices at 400 Medical Plz Ste 200, Lake St Louis, MO 63367. The listed phone number is (636) 625-2662.

What is Paul Hinton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Paul Hinton enrolled in Medicare?

Yes. Paul Hinton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Paul Hinton accept?

Health plans from Anthem Blue Cross and Blue Shield, Medica and Oscar Insurance Company list Paul Hinton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Paul Hinton affiliated with any hospitals?

According to CMS data, Paul Hinton is affiliated with Ssm St Joseph Health Center, Barnes Jewish Hospital, Ssm Health Depaul Hospital St Louis, Missouri Baptist Medical Center and Ssm St Joseph Hospital West.

When was this NPI record last updated?

The NPPES record for Paul Hinton was last updated on May 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.