Individual provider Active NPI

Dale M Stegeman, M.D.

  • Family Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1407834260
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36313 Issued in MO
Practice address
16216 Baxter Rd
Ste 340
Chesterfield, MO 63017-4770
Phone
(636) 537-3100
Fax
(636) 537-9195
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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 36313 MO Primary

Addresses

Primary practice location

16216 Baxter Rd
Ste 340
Chesterfield, MO 63017-4770

Mailing address

12847 Westledge LN
Saint Louis, MO 63131-2237
Phone (314) 966-8086

Other identifiers 1

IdentifierTypeStateIssuer
36313OtherMOSTATE LICENSE NUMBER

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
I20230224000324 MO Order and Referring Only - Family PracticePractitioner - Family Practice 5294713632

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Family Medicine Past Accepting new patients

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, 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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1407834260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12847 WESTLEDGE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312237",
            "telephone_number": "314-966-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16216 BAXTER RD",
            "address_2": "STE 340",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630174770",
            "telephone_number": "636-537-3100",
            "fax_number": "636-537-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGEMAN",
        "first_name": "DALE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "36313",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.