Individual provider Active NPI

Daniel L Duelm, PA -C

  • Physician Assistant
  • Troy, MO
National Provider Identifier
1023099314
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021038900 Issued in MO
Practice address
1165A E Cherry St
Troy, MO 63379-1520
Phone
(636) 528-3407
Fax
(636) 528-3346
NPI assigned
Nov 14, 2005
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007546 IL
Physician Assistant 363A00000X 2021038900 MO Primary

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

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, TX, IL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

4 Memorial Dr
Suite 130B
Alton, IL 62002-6704
Phone (618) 463-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Nov 10, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jun 1, 2019 Accepting new patients
Town Center Orthopaedic Associates PC CurrentSince Sep 11, 2018 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 9, 2017 Accepting new patients
Town Center Orthopaedic Associates, P.C. CurrentSince Sep 11, 2018 Accepting new patients
Southeast Alaska Regional Health Constortium CurrentSince Oct 9, 2017 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Nov 10, 2025 Accepting new patients
Virginia Spine Institute PLC PastSince Jul 1, 2006 Accepting new patients

Locations

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8519

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4 Memorial Dr
Ste 130
Alton, IL 62002
Phone (618) 463-7600

4 Memorial Dr
Ste 130B
Alton, IL 62002
Phone (618) 463-7600

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

  • Direct secure messaging: dduelm1213158@directc.mercy.net

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1023099314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165A E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-3407",
            "fax_number": "636-528-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165A E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-3407",
            "fax_number": "636-528-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUELM",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "PA -C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007546",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021038900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4 Memorial Dr Ste 130",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.