Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ilya Bunimovich, PA

Individual provider Medical Physician Assistant · NPI 1730852377

Ilya Bunimovich, PA is a Physician Assistant in Saint Louis, Missouri. Qualified in 2020, 6 years ago. Practices with SSM Health Care Group, a 923-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
6
Licensed in
MO
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone: (314) 257-8000
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2021013043 (MO)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 2021013043 (MO)

Record details

NPI number1730852377
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 29, 2021
Last updated in NPPESOctober 28, 2021
Certification dateOctober 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Saint Louis