MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA) – Physician Assistant, NPI 1164179792

MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2023037284 (MO). The NPI Number for MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA) is 1164179792

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA)
NPI
1164179792
Phone
(314) 251-6970
Address
10012 Kennerly Rd Ste 101
Enumeration Date
3 March 2022
Last Update Date
3 March 2026

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
4789048349
Group Practice PAC ID
6204832199
Professional Enrollment ID
I20230914002996
Address ID
MO631418221ST625XXRDXX501

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness95
Years active:4State licenses:1Other names

1,853 PHYSICIAN ASSISTANT in MO

Provider Addresses for MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA)

  • 10012 Kennerly Rd Ste 101

    Saint Louis, MO 631282197

    Phone: (314) 251-6970

    Type: Location

  • 901 Patients First Dr Ste 2500

    Washington, MO 630904700

    Phone: (314) 251-6970

    Type: Location

  • 625 S NEW BALLAS RD STE R7040

    SAINT LOUIS, MO 631418240

    Phone: (314) 251-6970

    Type: Location

  • 2411 HOLMES ST

    KANSAS CITY, MO 641082741

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-09-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230914002996IPhysician AssistantMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204832199View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Thoracic SurgeryGA
Cardiac SurgeryPA
Physician AssistantMO
-MO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
General Surgery, Thoracic SurgeryMO

Reviews

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Frequently asked questions

Where can patients find MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA)'s NPI?
You can confirm MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA) with NPI 1164179792; it appears in the national provider directory.
Is MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA)'s specialty in plain language?
Clinically, the directory lists MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA)?
We surface Saint Louis, Missouri for MS. SARAH KATHRYN VAN ROSSUM-O'CONNELL (PA) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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