IMPACT PHYSICIAN GROUP, MISSOURI, LLC
NPI 1962971531
Internal Medicine in Bridgeton, MO
About Impact Physician Group, Missouri, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IMPACT PHYSICIAN GROUP, MISSOURI, LLC (NPI 1962971531) is a healthcare organization registered as an internal medicine in Bridgeton, Missouri and active in the NPI registry since November 2018. The organization maintains 2 additional practice locations and lists Paul Miller, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Locations 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Impact Physician Group, Missouri, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
37Medicare enrollment records show 37 clinicians reassign Medicare billing to Impact Physician Group, Missouri, LLC, which bills Medicare for the services they deliver. Of these, 12 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 37Source: 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 Impact Physician Group, Missouri, LLC's NPI number?
The NPI number for Impact Physician Group, Missouri, LLC is 1962971531. It was assigned to this organization in the NPPES registry on November 13, 2018.
Where is Impact Physician Group, Missouri, LLC located?
Impact Physician Group, Missouri, LLC is located at 12380 De Paul Dr, Bridgeton, MO 63044. The listed phone number is (314) 447-9700.
What is Impact Physician Group, Missouri, LLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Impact Physician Group, Missouri, LLC enrolled in Medicare?
Yes. Impact Physician Group, Missouri, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Impact Physician Group, Missouri, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 37 clinicians in 5 Medicare specialties reassign their Medicare billing to Impact Physician Group, Missouri, LLC. 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 Nurse Practitioner (20), Internal Medicine (11) and Family Practice (3). Of these, 12 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Impact Physician Group, Missouri, LLC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Impact Physician Group, Missouri, LLC 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 Impact Physician Group, Missouri, LLC was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Impact Physician Group, Missouri, Llc · NPI 1962971531
Internal Medicine organization in Bridgeton, Missouri. Organization record, active in the CMS NPPES registry since November 13, 2018.
## Identity
- **NPI:** 1962971531 (Entity type: Organization)
- **Enumerated:** November 13, 2018
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Paul Miller, CEO
## Practice location
- **Address:** 12380 DE PAUL DR, Bridgeton, MO 63044-2511
- **Phone:** (314) 447-9700
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 37 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (20), Internal Medicine (11), Family Practice (3); 12 practice within 10 miles; [full list](https://npiprofile.com/npi/1962971531/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 19, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1962971531) · Data from the CMS NPPES public registry.