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DR. ANTHONY MARK MASI M.D.
NPI 1902884844
Internal Medicine - Sleep Medicine in Ballwin, MO

Active since December 31, 2005PECOS EnrolledAccepts Medicare Assignment
13975 MANCHESTER RD, SUITE 7, BALLWIN, MO 63011(636) 391-1222(636) 333-1259 Get Directions Write a Review

NPPES record last updated: June 6, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Anthony Mark Masi M.d. NPPES

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

DR. ANTHONY MARK MASI M.D. (NPI 1902884844) is an individual sleep medicine provider in Ballwin, Missouri, licensed in Missouri (R3P21) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1987).

NPPES Registry Identity

NPI1902884844
Entity TypeIndividualMale
Primary Taxonomy207RS0012X
Provider Legal NameDR. ANTHONY MARK MASICredential: M.D.
Location Address13975 MANCHESTER RD, SUITE 7Ballwin, MO 63011-4500
Mailing Address13975 Manchester Rd, Suite 7Ballwin, MO 63011-4500 · (636) 391-1222 · Fax (636) 333-1259
Phone(636) 391-1222
Fax(636) 333-1259
Sole ProprietorYes
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1987
Enumeration DateDecember 31, 2005
Last NPPES UpdateJune 6, 2012
✔ NPI 1902884844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License✔ Licensed in MO · R3P21
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License R3P21 (MO)
13975 MANCHESTER RD, Ballwin, MO 63011
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Other Identifiers 4

Medicare ID-Type Unspecified001013766MO
Medicaid203472246MO
Medicare UPINE48362MO
Other290015378MO · Railroad Medicare

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Anthony Mark Masi M.d. 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 ID5799789582
PECOS Enrollment IDI20100602000819
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.

Medicare Billing Reassignment

Medicare enrollment records show Anthony Masi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lung & Sleep Medicine, Inc.
Same address
Pulmonary Disease
13975 MANCHESTER RD, SUITE 7
Manchester, MO 63011
  • Reassigned Medicare billing, Missouri enrollment
NPI 1841487097 (314) 821-1222

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

Areas of Expertise CMS Part B claims 4

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 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.
368 services338 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.
73 services73 patients
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.
48 services39 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.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63011 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

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.
97%1,621 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%232 patients4/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
100%53 patients
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…
10%1,188 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
76%375 patients4/55-star benchmark: 100%
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+: 3% · 540 patients
1%540 patients4/55-star benchmark: 100%
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 18

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
24 suppliers468 claims468 services$33.39 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
19 suppliers204 claims204 services$75.56 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
20 suppliers187 claims447 services$28.37 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
18 suppliers222 claims1,009 services$16.76 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
16 suppliers175 claims847 services$12.39 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
24 suppliers394 claims394 services$47.90 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

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

DR. RONALD DENNIS GROSS DDS
Dentist (General Practice)
13975 MANCHESTER RD
BALLWIN, MO 63011
St. Louis County (636) 391-9904
EASTER SEALS MISSOURI, INC
Day Training, Developmentally Disabled Services
13975 MANCHESTER RD
BALLWIN, MO 63011
St. Louis County (636) 779-2250
SUSAN TORRILLO MASI LPC
Counselor (Professional)
13975 MANCHESTER RD, SUITE 7
BALLWIN, MO 63011
St. Louis County (314) 303-0790
EASTER SEALS MISSOURI, INC.
Day Training, Developmentally Disabled Services
13975 MANCHESTER RD
BALLWIN, MO 63011
St. Louis County (636) 779-2250
MIDWEST SLEEP DIAGNOSTICS, INC.
Clinic/Center (Sleep Disorder Diagnostic)
13975 MANCHESTER RD, SUITE 9
MANCHESTER, MO 63011
St. Louis County (636) 227-8787
LUNG & SLEEP MEDICINE, INC.
Internal Medicine (Pulmonary Disease)
13975 MANCHESTER RD, SUITE 7
MANCHESTER, MO 63011
St. Louis County (314) 821-1222
SUSAN MASI COUNSELING SOLUTIONS, LLC
Counselor (Professional)
13975 MANCHESTER RD, STE 7
BALLWIN, MO 63011
St. Louis County (314) 303-0790

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 Anthony Masi's NPI number?

The NPI number for Anthony Masi is 1902884844. It was assigned to this individual provider in the NPPES registry on December 31, 2005.

Where is Anthony Masi located?

Anthony Masi practices at 13975 Manchester Rd Suite 7, Ballwin, MO 63011. The listed phone number is (636) 391-1222.

What is Anthony Masi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Anthony Masi enrolled in Medicare?

Yes. Anthony Masi 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.

Which organization bills Medicare for Anthony Masi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anthony Masi reassigns Medicare benefits to Lung & Sleep Medicine, Inc. (Manchester, MO). The 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 Anthony Masi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Anthony Masi accept?

Health plans from Anthem Blue Cross and Blue Shield list Anthony Masi 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.

When was this NPI record last updated?

The NPPES record for Anthony Masi was last updated on June 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.