NPIMap

Individual provider Active NPI

Daniel Martin Weisel, MD

  • Family Medicine Physician
  • O'Fallon, MO
National Provider Identifier
1629506522
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2020023474 Issued in MO
Practice address
20 Progress Point Pkwy Ste 108
O Fallon, MO 63368-2207
Phone
(636) 344-2400
NPI assigned
May 23, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 2020023474 MO Primary

Addresses

Primary practice location

20 Progress Point Pkwy Ste 108
O Fallon, MO 63368-2207

Mailing address

20 Progress Point Pkwy Ste 108
O Fallon, MO 63368-2207
Phone (636) 344-2400

Other practice location 1

300 Pasteur Dr Rm HC 435
Stanford, CA 94305-2200
Phone (650) 723-5948

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908000754 MO Practitioner - Family Practice 4385061373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

20 Progress Point Pkwy
Suite 108
O Fallon, MO 63368-2207
Phone (636) 344-2400

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Physician Groups LC CurrentSince Oct 1, 2020 Accepting new patients

Locations

20 Progress Point Pkwy
Ste 108
O Fallon, MO 63368
Phone (636) 344-2400

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

Interoperability endpoints

  • Direct secure messaging: dweisel1287092@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629506522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROGRESS POINT PKWY STE 108",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682207",
            "telephone_number": "636-344-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROGRESS POINT PKWY STE 108",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682207",
            "telephone_number": "636-344-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr Rm HC 435",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-5948",
            "fax_number": "650-723-3045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISEL",
        "first_name": "DANIEL",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2020023474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20 Progress Point Pkwy Ste 108",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633682207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.