Active NPI
Benjamin Modde, DPT
- Physical Therapist
- High Ridge, MO
National Provider Identifier
1013550821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2019030595
- Practice address
- 32 Dillon Plaza Dr
High Ridge, MO 63049-2478 - Phone
- (636) 677-3100
- NPI assigned
- Oct 24, 2019
- Last updated
- Nov 13, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2019030595 | MO | Primary |
Addresses
Primary practice location
32 Dillon Plaza Dr
High Ridge, MO 63049-2478
Mailing address
409 W Argonne Dr
Kirkwood, MO 63122-4133
Other practice location 1
3518 Laclede Ave
Saint Louis, MO 63103-2011
Phone (314) 977-2323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Select Rehab St. Louis, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
-
dba SSM Physical Therapy
- Rehabilitation Practitioner
- Breese, IL
- NPI 1740166347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762992000000",
"number": "1013550821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 W ARGONNE DR",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631224133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 DILLON PLAZA DR",
"city": "HIGH RIDGE",
"state": "MO",
"postal_code": "630492478",
"telephone_number": "636-677-3100"
}
],
"practiceLocations": [
{
"address_1": "3518 Laclede Ave",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631032011",
"country_code": "US",
"telephone_number": "314-977-2323",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MODDE",
"first_name": "BENJAMIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-24",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2019030595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Ridge, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.