Individual provider Active NPI

Fadi F Siyam, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Louis, MO
National Provider Identifier
1558526574
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2013002833 Issued in MO
Practice address
12700 Southfork Rd Ste 205
Saint Louis, MO 63128-3201
Phone
(314) 525-7350
Fax
(314) 525-7356
NPI assigned
Jul 21, 2008
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2013002833 MO Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD220356 OR
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036150752 IL

Addresses

Primary practice location

12700 Southfork Rd Ste 205
Saint Louis, MO 63128-3201

Mailing address

12700 Southfork Rd Ste 205
Saint Louis, MO 63128-3201
Phone (314) 525-7350

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fsiyam262424@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140207000856 MO Practitioner - EndocrinologyPractitioner - Internal Medicine 0143459420 Reassigns benefits to 1 organization
I20191107001601 IL Practitioner - Endocrinology 0143459420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Endocrinology LLCGroup PAC ID 7416073531, 7 clinicians

Practice addresses (Care Compare)

12700 Southfork Rd
Suite 205
Saint Louis, MO 63128-3201
Phone (314) 525-7350

621 S New Ballas Rd
Suite 460a
Saint Louis, MO 63141-8259
Phone (314) 251-4330

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036150752ILMDEndocrinology, Diabetes & Metabolism Physician
2013002833MOMDEndocrinology, Diabetes & Metabolism Physician
MD220356ORMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJL Health Systems Inc CurrentSince Aug 9, 2021 Accepting new patients
Mercy Clinic Endocrinology, LLC Endocrinology, Diabetes & Metabolism CurrentSince Oct 24, 2024 Accepting new patients
Physician Groups LC Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

775 Sunset Blvd
#B
O Fallon, IL 62269
Phone (618) 235-8500

12700 Southfork Rd
Ste 205
Saint Louis, MO 63128
Phone (314) 525-7350

621 S New Ballas Rd
Ste 460A
Saint Louis, MO 63141
Phone (314) 251-4330

Organizations & group practices 4

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 5

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1558526574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-525-7350",
            "fax_number": "314-525-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-525-7350",
            "fax_number": "314-525-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIYAM",
        "first_name": "FADI",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2013002833",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OR",
            "license": "MD220356",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036150752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fsiyam262424@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "775 Sunset Blvd Ste B",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.