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

Mr. Jastin L Antisdel, MD

Individual provider Otolaryngology Physician · NPI 1073714564

Mr. Jastin L Antisdel, MD practises Otolaryngology in Saint Louis, Missouri. Graduated from Saint Louis University School of Medicine in 2004, 22 years ago. Practices with SSM Health Care Group, a 923-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia and Missouri.

Years since qualifying
22
Trained at
Saint Louis University School of Medicine
Licensed in
GA, MO
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1225 S Grand Blvd Garden Level
Saint Louis, MO 63104-1016
Phone: (314) 977-5110
Fax: (314) 977-7686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 555 N New Ballas Rd Ste 260, Saint Louis, MO 63141-6886 — (314) 977-6362

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 2005036993 (MO)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 062018 (GA)

Record details

NPI number1073714564
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 30, 2007
Last updated in NPPESJanuary 13, 2021
Certification dateJanuary 13, 2021

Medicare enrollment

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

Medicare specialtyOTOLARYNGOLOGY
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients102
Services billed 457 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at SSM Health Care Group

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 923 clinicians in the practice; 12 are shown here.

Other providers in Saint Louis