Individual provider Active NPI

Anne Corinne Walentik, D.O.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1174813133
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015018615 Issued in MO
Practice address
1402 S Grand Blvd
Saint Louis University Hospital-Internal Medicine
Saint Louis, MO 63104-1004
Phone
(314) 577-6143
NPI assigned
Apr 12, 2011
Last updated
Aug 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015018615 MO Primary
Pediatrics Physician 208000000X 2015018615 MO

Addresses

Primary practice location

1402 S Grand Blvd
Saint Louis University Hospital-Internal Medicine
Saint Louis, MO 63104-1004

Mailing address

1402 S Grand Blvd
Saint Louis University Hospital-Internal Medicine
Saint Louis, MO 63104-1004
Phone (314) 577-6143

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
I20151027001835 MO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5890004121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

1225 S Grand Blvd
Saint Louis, MO 63104-1016

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015018615MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Dec 27, 2016 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Cardinal Glennon Children's Hospital Pediatrics CurrentSince Dec 27, 2016 Accepting new patients
SSM Cardinal Glennon Children's Hospital Past Accepting new patients
SSM-Sluh Inc Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1402 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 577-8762

3518 Laclede Ave
Saint Louis, MO 63103
Phone (314) 977-2323

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

3660 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

Interoperability endpoints

  • Direct secure messaging: awalentik2915@direct-ehr-ssmhc.com

Organizations & group practices 6

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.

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": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1174813133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "address_2": "SAINT LOUIS UNIVERSITY HOSPITAL-INTERNAL MEDICINE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-577-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "address_2": "SAINT LOUIS UNIVERSITY HOSPITAL-INTERNAL MEDICINE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-577-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALENTIK",
        "first_name": "ANNE",
        "middle_name": "CORINNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015018615",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2015018615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.