Diane Denise Block, NP
Individual provider Active NPI Nurse Practitioner · Fenton, MO
NPI 1699158196 · NPPES record last updated Nov 19, 2020
Key facts
- NPI
- 1699158196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2015013958 (MO)
- Practice address
- 1345 Smizer Mill Rd Ste 1100
Fenton, MO 63026-7305 - Phone
- (636) 496-5023
- NPI assigned
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mercy Clinic East Communities
Practice addresses (Care Compare)
5194 Jeremiah Blvd
Hillsboro, MO 63050-5815
Phone (636) 543-2328
Hospital & facility affiliations
- Mercy Hospital Jefferson
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730012214 | MO | Practitioner - Nurse Practitioner | 4587978861 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic East Communities | Current |
Accepting new patients |
Locations
5194 Jeremiah Blvd
Hillsboro, MO 63050
Phone (636) 543-2328
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2015013958 | MO | Yes |
Addresses
Primary practice location
1345 Smizer Mill Rd Ste 1100
Fenton, MO 63026-7305
Mailing address
PO Box 955534
Saint Louis, MO 63195-5534
Other practice location 1
1011 Bowles Ave
Suite 300
Fenton, MO 63026-2395
Phone (636) 496-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2015013958 | Other | MO | LICENSE |
Other names
- Diane Denise Sitarski
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | dblock140081@direct-ehr-ssmhc.com | Direct |
Other providers in Fenton, MO
- Denise P Blackburn
- Katherine A. Blackburn
- Joseph A. Blaes
- Danielle Rebecca Blake
- April Louise Blandford
- Kellie L Blow
- Michael Scott Boedefeld
- Emily Bohnert
- Bon Vivant Adult Day Club L.L.C.
- Susan Elizabeth Bonk
All providers in Fenton, MO · Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.