SSM HEALTH MEDICAL GROUP
NPI 1760456743
Internal Medicine in Maryland Heights, MO

Active since February 15, 2006CLIA 26D2178132 · Microscopy
2024 DORSETT VLG, MARYLAND HEIGHTS, MO 63043(314) 590-0550(314) 590-0560 Get Directions Write a Review

NPPES record last updated: January 15, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ssm Health Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SSM HEALTH MEDICAL GROUP (NPI 1760456743) is a healthcare organization registered as an internal medicine in Maryland Heights, Missouri and active in the NPI registry since February 2006. The organization holds a CLIA Microscopy certificate valid through January 27, 2028 and lists Laura L Pullum, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1760456743
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSSM DEPAUL MEDICAL GROUP, INC.
Location Address2024 DORSETT VLGMaryland Heights, MO 63043-2208
Mailing Address1551 Wall St, Suite 310Saint Charles, MO 63303-3539 · (636) 669-2268 · Fax (314) 209-8127
Fax(314) 590-0560
Organization SubpartNo
Authorized OfficialLaura L PullumBilling Manager · (636) 669-2434
Enumeration DateFebruary 15, 2006
Last NPPES UpdateJanuary 15, 2016
NPI 1760456743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X
Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X
Also ListedNeurological SurgeryTaxonomy 207T00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedGeneral PracticeTaxonomy 208D00000X
2024 DORSETT VLG, Maryland Heights, MO 63043

Other Names 1

Doing Business AsSsm Health Medical Group

Other Identifiers 3

Medicare PIN000013572MO
Medicaid502915705MO
OtherCJ7983MO · Railroad Medicare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 26D2178132

Ssm Health Medical Group · Maryland Heights, MO
Active · expires Jan 27, 2028
CLIA Number26D2178132
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2026
Certificate Expiration DateJanuary 27, 2028
Laboratory DirectorHamnah Siddiqui
Laboratory Phone(314) 590-0550
Laboratory LocationSsm Health Medical Group2024 Dorsett Village, Maryland Heights, MO 63043
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Durable Medical Equipment & Medical Supplies
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Family Medicine
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Family Medicine
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Nurse Practitioner (Adult Health)
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Family Medicine
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Family Medicine
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043
Family Medicine
2024 DORSETT VLG
MARYLAND HEIGHTS, MO 63043

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760456743, enumerated as an "organization" on February 15, 2006.

The provider is located at 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 and the phone number is (314) 590-0550.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare,. Please consult your insurance carrier or call the provider to verify.