Individual provider Active NPI

Paul Hallemann, PT

  • Physical Therapist
  • Ellisville, MO
National Provider Identifier
1396797296
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
104500 Issued in MO
Practice address
1346 Clarkson Clayton Ctr
Ellisville, MO 63011-2145
Phone
(636) 227-5200
Fax
(636) 227-5202
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 104500 MO Primary

Addresses

Primary practice location

1346 Clarkson Clayton Ctr
Ellisville, MO 63011-2145

Mailing address

607 Dewey Ave NW
Ste 300
Grand Rapids, MI 49504-7335
Phone (616) 356-5000

Other identifiers 3

IdentifierTypeStateIssuer
P00213397OtherMORAILROAD MEDICARE
12322039OtherMOCAQH
P01333525OtherMORAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040113000530 MO Practitioner - Physical Therapist in Private Practice 3971403007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Babar Enterprises LLCGroup PAC ID 2365342318, 19 clinicians

Practice addresses (Care Compare)

1346 Clarkson Clayton Ctr
Ellisville, MO 63011-2145
Phone (636) 227-5200

4800 Mexico Rd
Suite 104
Saint Peters, MO 63376-1666
Phone (636) 928-4199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Babar Enterprises LLC Physical Therapist CurrentSince Oct 1, 2003 Accepting new patients
Babar Enterprises LLC Physical Therapist Past Accepting new patients

Locations

1346 Clarkson Clayton Ctr
Ellisville, MO 63011
Phone (636) 227-5200

2982 Highway K
O Fallon, MO 63368
Phone (636) 978-5255

713 N New Ballas Rd
Saint Louis, MO 63141
Phone (314) 991-0480

4800 Mexico Rd
Ste 104
Saint Peters, MO 63376
Phone (636) 916-4625

Organizations & group practices 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1396797296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 DEWEY AVE NW",
            "address_2": "STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495047335",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 CLARKSON CLAYTON CTR",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112145",
            "telephone_number": "636-227-5200",
            "fax_number": "636-227-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLEMANN",
        "first_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "104500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00213397",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12322039",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01333525",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.