Individual provider Active NPI

Mark Edward Halstead, MD

  • Pediatric Sports Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1598783227
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
2004011774 Issued in MO
Practice address
14532 S Outer 40 Rd
Dept Orthopaedic Surgery, Ste 200
Chesterfield, MO 63017-5705
Phone
(314) 514-3500
Fax
(314) 878-7678
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 2004011774 MO Primary

Addresses

Primary practice location

14532 S Outer 40 Rd
Dept Orthopaedic Surgery, Ste 200
Chesterfield, MO 63017-5705

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 514-3500

Other identifiers 1

IdentifierTypeStateIssuer
209144609MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20040726000632 MO Practitioner - Sports MedicinePractitioner - General PracticePractitioner - Orthopedic Surgery 4486634714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

20 Progress Point Pkwy
Suite 114
O Fallon, MO 63368-2207
Phone (314) 514-3500

4921 Parkview PL
Saint Louis, MO 63110-1032
Phone (314) 514-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 1, 2004 Accepting new patients
Washington University CurrentSince Jul 1, 2004 Accepting new patients
Washington University Past Accepting new patients

Locations

14532 South Outer 40 Rd
Ste 200
Chesterfield, MO 63017

14532 South Outer 40 Rd
Ste 210
Chesterfield, MO 63017

13001 North Outer 40 Rd
Ste 1C
Chesterfield, MO 63017

20 Progress Point Pkwy
Ste 114
O Fallon, MO 63368

660 S Euclid Ave
#8233
Saint Louis, MO 63110
Phone (314) 747-2555

660 S Euclid Ave
#8514
Saint Louis, MO 63110
Phone (314) 286-1937

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

4921 Parkview Pl
Ste 6A6B12A
Saint Louis, MO 63110
Phone (314) 747-2551

Interoperability endpoints

  • Direct secure messaging: mhalstead154431@direct.carenet.org

Organizations & group practices 3

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.

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1598783227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-514-3500",
            "fax_number": "314-878-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14532 S OUTER 40 RD",
            "address_2": "DEPT ORTHOPAEDIC SURGERY, STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175705",
            "telephone_number": "314-514-3500",
            "fax_number": "314-878-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MO",
            "license": "2004011774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209144609",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "14532 S Outer 40 Rd",
            "address_2": "Dept Orthopaedic Surgery, Ste 200",
            "city": "Chesterfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630175705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.