Daniel L Duelm, PA -C
Individual provider Active NPI Physician Assistant · Troy, MO
NPI 1023099314 · NPPES record last updated Aug 6, 2026
Key facts
- NPI
- 1023099314
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2021038900 (MO)
- Practice address
- 1165A E Cherry St
Troy, MO 63379-1520 - Phone
- (636) 528-3407
- Fax
- (636) 528-3346
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fairview Heights Medical Group SC
Practice addresses (Care Compare)
4 Memorial Dr
Suite 130B
Alton, IL 62002-6704
Phone (618) 463-7600
Hospital & facility affiliations
- Mercy Hospital St Louis
- Jersey Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in DC, TX, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090123000120 | DC | Practitioner - Physician Assistant | 2062459803 | Reassigns benefits to 3 organizations |
| I20171114003362 | TX | Practitioner - Physician Assistant | 2062459803 | Reassigns benefits to 1 organization |
| I20200330002293 | IL | Practitioner - Physician Assistant | 2062459803 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021038900 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Heights Medical Group SC | Current |
Accepting new patients | |
| Centers for Advanced Orthopaedics, LLC | Current |
Accepting new patients | |
| Town Center Orthopaedic Associates PC | Current |
Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current |
Accepting new patients | |
| Southeast Alaska Regional Health Constortium | Current |
Accepting new patients | |
| Fairview Heights Medical Group SC | Current |
Accepting new patients | |
| Virginia Spine Institute PLC | Past |
Accepting new patients |
Locations
3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000
222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423
4 Memorial Dr
Ste 130B
Alton, IL 62002
Phone (618) 463-7600
4 Memorial Dr
Ste 130
Alton, IL 62002
Phone (618) 463-7600
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876
1860 Town Center Dr
Ste 300
Reston, VA 20190
Phone (703) 483-4684
Interoperability endpoints
- dduelm1213158@directc.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085007546 | IL | |
| Physician Assistant | 363A00000X | 2021038900 | MO | Yes |
Addresses
Primary practice location
1165A E Cherry St
Troy, MO 63379-1520
Mailing address
1165A E Cherry St
Troy, MO 63379-1520
Phone (636) 528-3407
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 970018319 | Other | VA | RAIL ROAD MEDICARE PIN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) |
Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.