SSM HEALTH MEDICAL GROUP
NPI 1760456743
Internal Medicine in Maryland Heights, MO
NPI Status: Active since February 15, 2006
Contact Information
2024 DORSETT VLG
MARYLAND HEIGHTS, MO
ZIP 63043
Phone: (314) 590-0550
Fax: (314) 590-0560
- Organization
- Internal Medicine
- CLIA Number: 26D2178132
- CLIA Cert. Type: PPMP
- CLIA Exp. Date: 01-27-2026
About SSM HEALTH MEDICAL GROUP
Ssm Health Medical Group is an internist established in Maryland Heights, Missouri operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1760456743 assigned on February 2006. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Ssm Health Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Ssm Health Medical Group. The authorized official of this NPI record is Ms. Laura L Pullum (Billing Manager)
- NPI
- 1760456743
- Provider Legal Name
- SSM DEPAUL MEDICAL GROUP, INC.
- Other Organization Name
- SSM HEALTH MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043
- Location Phone
- (314) 590-0550
- Location Fax
- (314) 590-0560
- Mailing Address
- 1551 WALL ST SUITE 310 SAINT CHARLES, MO 63303
- Mailing Phone
- (636) 669-2268
- Mailing Fax
- (314) 590-0560
- Is Sole Proprietor?
- N/A
- Is Organization Subpart?
- No
- Enumeration Date
- 02-15-2006
- Last Update Date
- 01-15-2016
- Code Navigator
An internist like Ssm Health Medical Group is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 3 | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | |
| 5 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 6 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
| 7 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Anthem Blue Cross and Blue Shield
- Anthem Bronze Pathway 20% for HSA - EPO
- Anthem Bronze Pathway 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 6500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500/50% Standard - EPO
- Anthem Bronze Pathway 9450 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Catastrophic Pathway 9450 - EPO
- Anthem Gold Pathway 1500/25% Standard - EPO
- Anthem Silver Pathway 2950 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 3950 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 4950 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5900/40% Standard - EPO
- Anthem Silver Pathway 7050 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Medicare
Medicaid
Railroad Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000013572 | MEDICARE PIN (08) | MO | |
| 502915705 | MEDICAID (05) | MO | |
| CJ7983 | OTHER (01) | MO | RAILROAD MEDICARE |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D2178132
- Facility Type
- Physician Office
- Certificate Effective Date
- January 28, 2024
- Certificate Expiration Date
- January 27, 2026
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Ssm Health Medical Group in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 6 | 0 | 4 | 5 | 6 | 7 | 4 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 8 | 5 | 12 | 7 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 8 + 5 + 1 + 2 + 7 + 8 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1760456743 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1780900456 | KATHY MILLER NP Individual | Nurse Practitioner (Family) | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1194033316 | SSM MEDICAL GROUP INC. Organization | Durable Medical Equipment & Medical Supplies | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1619940277 | DR. MATTHEW MIRIANI D.O. Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1548233455 | DR. TIMOTHY W JENNINGS D.O. Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1942821707 | MARY RACHEL BORDERS NP Individual | Nurse Practitioner (Adult Health) | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1174597629 | DR. FREDRIC A PRATER D.O. Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1821031774 | LEONARD G LUCAS DO Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1083724272 | DR. SHEERIN BADRI STURM DO Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1902169972 | CHARLES S LARSEN D.O. Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1578827101 | DR. JAMES RICHARD YORK III D.O. Individual | Family Medicine | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1750700928 | MARINA FISCHER Individual | Nurse Practitioner (Family) | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
| 1366189946 | NIKITA SCHELLHARDT NP Individual | Nurse Practitioner (Family) | 2024 DORSETT VLG MARYLAND HEIGHTS, MO 63043 (314) 590-0550 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760456743, enumerated in the NPI registry 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
This medical organization specializes in 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 make sure your health plan is currently accepted.
The provider's CLIA number is 26D2178132 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on February 15, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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