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

Samuel R Nathan, PA-S

Individual provider Physician Assistant · NPI 1083469142

Samuel R Nathan, PA-S is a Physician Assistant in Wentzville, Missouri. Qualified in 2024, 2 years ago. Practices with SSM Medical Group Inc, a 560-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
2
Licensed in
MO
In the registry since
2024
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Practice location Address checks out

801 Medical Dr Ste 400
Wentzville, MO 63385-3824
Phone: (636) 332-8455
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1475 Kisker Rd Ste 100, Saint Charles, MO 63304-8787 — (636) 332-8455

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2024027697 (MO)

Record details

NPI number1083469142
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-S
Sole proprietorYes
NPI enumeratedApril 22, 2024
Last updated in NPPESAugust 1, 2024
Certification dateAugust 1, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Wentzville