Individual provider Active NPI

David E Hartenbach, M.D.

  • Pediatrics Physician
  • Chesterfield, MO
National Provider Identifier
1154302131
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R5N56 Issued in MO
Practice address
13001 N Outer 40 Rd Ste 320
Chesterfield, MO 63017-5941
Phone
(314) 567-7337
Fax
(314) 851-4476
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R5N56 MO Primary

Addresses

Primary practice location

13001 N Outer 40 Rd Ste 320
Chesterfield, MO 63017-5941

Mailing address

PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 567-7337

Other identifiers 8

IdentifierTypeStateIssuer
92215275OtherMOBLUE SHIELD
1956V34311OtherMOHEALTHCARE USA
40116OtherMOGHP
4135142OtherMOAETNA
138492OtherMOHEALTHLINK
22999OtherMOBCBS
F07321OtherMOMERCY
1200167OtherMSUHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R5N56MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Multispecialty Group Inc. Pediatrics CurrentSince Apr 5, 2020 Accepting new patients

Locations

13001 North Outer 40 Rd
Ste 320
Town and Country, MO 63017
Phone (314) 567-7337

Interoperability endpoints

  • Direct secure messaging: david.hartenbach.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 1

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1154302131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-567-7337",
            "fax_number": "314-851-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 N OUTER 40 RD STE 320",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175941",
            "telephone_number": "314-567-7337",
            "fax_number": "314-851-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTENBACH",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R5N56",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "92215275",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "1956V34311",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "40116",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4135142",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "138492",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "22999",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "F07321",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1200167",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.