Adam Nikolaus Benckendorf, DO
Individual provider Active NPI Anesthesiology Physician · Saint Louis, MO
NPI 1801423652 · NPPES record last updated May 30, 2024
Key facts
- NPI
- 1801423652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 2024009634 (MO)
- Practice address
- 1402 S Grand Blvd # M260
Saint Louis, MO 63104-1004 - Phone
- (314) 577-8933
- NPI assigned
- Mar 23, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SSM Health Care Group
SSM Health Slu Hospital Anesthesia Physician Billing LLC
Practice addresses (Care Compare)
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000
Hospital & facility affiliations
- SSM Health Saint Louis University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 68.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.22
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240613003407 | MO | Practitioner - Anesthesiology | 4183041205 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024009634 | MO | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care Group | Anesthesiology | Current |
Accepting new patients |
| SSM Health Care Group | Current |
Accepting new patients | |
| SSM Health Slu Hospital Anesthesia Physician Billing, LLC | Anesthesiology | Current |
Accepting new patients |
Locations
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
1402 S Grand Blvd
#M260
Saint Louis, MO 63104
Phone (314) 617-2919
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390
Interoperability endpoints
- abenckendorf270600@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 2024009634 | MO | Yes |
Addresses
Primary practice location
1402 S Grand Blvd # M260
Saint Louis, MO 63104-1004
Mailing address
4068 Federer St
Saint Louis, MO 63116-2815
Phone (314) 894-0021
Other providers in Saint Louis, MO
- Andrea Michelle Belstle
- Janet Elizabeth Beltz
- Merav Ben David
- Gary William Bena
- Benchmark Healthcare of Willowbrooke, LLC
- Andrew Benckendorf
- Alyssa Bender
- Barbara Bender
- David Andrew Bender
- Joy Kristine Bender
All providers in Saint Louis, MO · Anesthesiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2024. 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.