Individual provider Active NPI

Brenda L Seidel, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1053635748
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2010008797 Issued in MO
Practice address
12855 N 40 Dr Ste 125
Saint Louis, MO 63141-8663
Phone
(314) 806-1770
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2010008797 MO Primary
Adult Health Nurse Practitioner 363LA2200X 2090425177 IL
Adult Health Nurse Practitioner 363LA2200X 2010008797 MO

Addresses

Primary practice location

12855 N 40 Dr Ste 125
Saint Louis, MO 63141-8663

Mailing address

1235 Glenmeade Dr
Maryland Heights, MO 63043-3618
Phone (314) 806-1770

Other identifiers 1

IdentifierTypeStateIssuer
2010008797OtherMOLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100717000242 MO Practitioner - Nurse Practitioner 0941332563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.16 of 100Reported as group
Quality
55.68
Promoting interoperability
100
Improvement activities
40
Cost
74.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2090425177ILMDAdult Health Nurse Practitioner
2010008797MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of St. Louis, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brendaseidel@slus.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1053635748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 GLENMEADE DR",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433618",
            "telephone_number": "314-806-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 125",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418663",
            "telephone_number": "314-806-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDEL",
        "first_name": "BRENDA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010008797",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "2090425177",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2010008797",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2010008797",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.