Individual provider Active NPI

Denise L Buck, M. D.

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1083760599
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
108334 Issued in MO
Practice address
8793 Watson Rd
Saint Louis, MO 63119-5111
Phone
(314) 968-0700
Fax
(314) 961-0909
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 108334 MO Primary

Addresses

Primary practice location

8793 Watson Rd
Saint Louis, MO 63119-5111

Mailing address

8793 Watson Rd
Saint Louis, MO 63119-5111
Phone (314) 968-0700

Other practice location 1

9417 S Broadway
Saint Louis, MO 63125-2009
Phone (314) 833-4030

Other identifiers 2

IdentifierTypeStateIssuer
203822606MedicaidMO
080187851OtherMORAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110718000269 MO Practitioner - Internal Medicine 2365610425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Research and Education in Family MedicineGroup PAC ID 6608833587, 9 clinicians

Practice addresses (Care Compare)

9417 S Broadway
Saint Louis, MO 63125-2009
Phone (314) 833-4030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Health Professionals PC Family Medicine CurrentSince Dec 1, 1998 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

11520 Saint Charles Rock Rd
Ste 106
Bridgeton, MO 63044
Phone (314) 209-9331

8793 Watson Rd
Saint Louis, MO 63119
Phone (314) 961-9080

3933 S Broadway
Saint Louis, MO 63118
Phone (314) 865-3333

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.

Hospital & facility affiliations 2

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1083760599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8793 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195111",
            "telephone_number": "314-968-0700",
            "fax_number": "314-961-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8793 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195111",
            "telephone_number": "314-968-0700",
            "fax_number": "314-961-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9417 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631252009",
            "country_code": "US",
            "telephone_number": "314-833-4030",
            "fax_number": "314-833-4031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "DENISE",
        "middle_name": "L",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "108334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203822606",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080187851",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.