NPIMap

Individual provider Active NPI

Dale M Henselmeier, M.D.

  • Family Medicine Physician
  • Bridgeton, MO
National Provider Identifier
1699748756
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8831 Issued in MO
Practice address
12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2510
Phone
(314) 291-1074
Fax
(314) 290-0802
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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 R8831 MO Primary

Addresses

Primary practice location

12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2510

Mailing address

PO Box 955534
Saint Louis, MO 63195-2510

Other identifiers 1

IdentifierTypeStateIssuer
P00075900OtherMORAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dhenselmeier6913@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20100902000525 MO Practitioner - Family Practice 5395869911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2515
Phone (314) 209-5100

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • SSM Health at Home Home Health-St. Louis Home health agency, Saint Louis, MO, CCN 267184
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Depaul Medical Group, Inc. Family Medicine Past Accepting new patients
County of St Louis Division of Fiscal Management Past Accepting new patients

Locations

12255 De Paul Dr
Ste 600
Bridgeton, MO 63044
Phone (314) 209-5100

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Interoperability endpoints

  • Direct secure messaging: dhenselmeier6913@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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1699748756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "SUITE 600",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-291-1074",
            "fax_number": "314-290-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSELMEIER",
        "first_name": "DALE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R8831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00075900",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhenselmeier6913@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dhenselmeier6913@direct-ehr-ssmhc.com",
            "address_1": "12255 De Paul Dr",
            "address_2": "Suite 600",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "12255 De Paul Dr",
            "address_2": "Suite 600",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.