Individual provider Active NPI

Daniel Peter Alyea, MD

  • Anesthesiology Physician
  • Ballwin, MO
National Provider Identifier
1376614685
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036086822 Issued in IL
Practice address
339 Consort Dr
Ballwin, MO 63011-4439
Phone
(636) 386-9224
NPI assigned
Nov 10, 2006
Last updated
Aug 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036086822 IL Primary

Addresses

Primary practice location

339 Consort Dr
Ballwin, MO 63011-4439

Mailing address

339 Consort Dr
Credentialing Department
Ballwin, MO 63011-4439
Phone (636) 386-9224

Other identifiers 1

IdentifierTypeStateIssuer
036086822001MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040611000472 IL Practitioner - Anesthesiology 4688562846 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Anesthesiology CurrentSince Oct 1, 2022 Accepting new patients
Midwest Anesthesia Associates, P.C. CurrentSince Oct 1, 2022 Accepting new patients
Hannibal Regional Healthcare System Inc Past Accepting new patients
Anesthesiology Consultants LTD Anesthesiology Past Accepting new patients
Northeast Missouri Imaging Associates, Inc. Past Accepting new patients
Chicago Area Partners in Anesthesia LLC Anesthesiology Past Accepting new patients
Physician Anesthesia Services, LLC Anesthesiology Past Accepting new patients

Locations

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

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1376614685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALYEA",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036086822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086822001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.