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

Shannon Michelle Root Bast, PA

Individual provider Physician Assistant · NPI 1760946669

Shannon Michelle Root Bast, PA is a Physician Assistant in Bridgeton, Missouri. Qualified in 2020, 6 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
6
Licensed in
MO
In the registry since
2019
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 →

Practice location Address checks out

12266 De Paul Dr Ste 205
Bridgeton, MO 63044-2514
Phone: (314) 218-2300
Show map & directions

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

Additional practice locations (1)

  • 8918 W 64th Pl Apt 302, Merriam, KS 66202-3688 — (314) 954-9951

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2020023147 (MO)

Record details

NPI number1760946669
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 24, 2019
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026

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 Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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