Active NPI
Sean Lewis Edelstein, MD
- Ophthalmology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 2005019369
- Practice address
- 1225 S Grand Blvd
Saint Louis, MO 63104-1016 - Phone
- (314) 977-5200
- Fax
- (314) 977-9910
- NPI assigned
- May 27, 2006
- Last updated
- Jan 19, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2005019369 | MO | |
| Internal Medicine Physician | 207R00000X | 2005019369 | MO | |
| Ophthalmology Physician | 207W00000X | 2005019369 | MO | Primary |
Addresses
Primary practice location
1225 S Grand Blvd
Saint Louis, MO 63104-1016
Mailing address
1008 S Spring Ave
Saint Louis, MO 63110-2520
Phone (314) 977-4010
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679520605 | Medicaid | MO | |
| 200839009 | Medicaid | MO |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | sedelstein24185@direct-ehr-ssmhc.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000
1225 S Grand Blvd
Saint Louis, MO 63104-1016
3990 N Illinois St
Swansea, IL 62226-1919
Phone (618) 277-1130
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 68.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.22
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.84 of 100
- Quality
- 92.01
- Improvement activities
- 40
- Cost
- 76.78
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 156 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005019369 | MO | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JFJ Eyecare LTD | Current | Accepting new patients | |
| SSM Health Care Group | Emergency Medicine | Current | Accepting new patients |
| JFJ Eyecare, LTD | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| North County Emergency Physicians, LLP | Emergency Medicine | Past | Accepting new patients |
Locations
4900 W Main St
Belleville, IL 62226
Phone (618) 235-2400
103 Clintonian Plz
Breese, IL 62230
Phone (618) 526-7447
408 W 2nd St
Centralia, IL 62801
Phone (618) 532-5531
12 Professional Park Dr
Maryville, IL 62062
Phone (618) 288-7266
3990 N Illinois St
Swansea, IL 62226
Phone (618) 235-3100
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390
12692 Lamplighter Square Shpg Ctr
Saint Louis, MO 63128
Phone (314) 432-5478
1402 S Grand Blvd
#G
Saint Louis, MO 63104
1755 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 256-3400
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
6420 Clayton Rd
#303
Saint Louis, MO 63117
8820 Manchester Rd
Saint Louis, MO 63144
Phone (314) 963-8100
Interoperability endpoints
- sedelstein24185@direct-ehr-ssmhc.com
Organizations & group practices 5
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.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
Emergency Medicine
-
dba SLUCare Physician Group
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
- Emergency Medicine Physician
- Florissant, MO
- NPI 1356366934
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health Saint Louis University Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1679520605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 S SPRING AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102520",
"telephone_number": "314-977-4010",
"fax_number": "314-977-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016",
"telephone_number": "314-977-5200",
"fax_number": "314-977-9910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELSTEIN",
"first_name": "SEAN",
"middle_name": "LEWIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2021-01-19",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2005019369",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2005019369",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MO",
"license": "2005019369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679520605",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200839009",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1225 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041016",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sedelstein24185@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "sedelstein24185@direct-ehr-ssmhc.com",
"address_1": "1225 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041016",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.