NPIMap

Individual provider Active NPI

Mitchell Elting, MD

  • Family Medicine Physician
  • Fenton, MO
National Provider Identifier
1841725918
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M14507 Issued in ID
Practice address
1345 Smizer Mill Rd
Fenton, MO 63026-7305
Phone
(636) 496-5023
NPI assigned
Apr 26, 2017
Last updated
May 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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 M14507 ID Primary

Addresses

Primary practice location

1345 Smizer Mill Rd
Fenton, MO 63026-7305

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Melting@famhealth.direct.emds.com

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
I20220329001170 MO Practitioner - Family Practice 5496178014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1345 Smizer Mill Rd
Fenton, MO 63026-7305
Phone (636) 496-5040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M14507IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince May 16, 2022 Accepting new patients
SSM Health Care St. Louis CurrentSince May 16, 2022 Accepting new patients
SSM Medical Group Inc. CurrentSince May 15, 2022 Accepting new patients
SSM Medical Group, Inc. CurrentSince May 15, 2022 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1345 Smizer Mill Rd
Fenton, MO 63026
Phone (636) 496-4030

1120 Shackelford Rd
Florissant, MO 63031
Phone (314) 830-5805

2022 Dorsett Vlg
Maryland Heights, MO 63043
Phone (314) 520-0520

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: melting@famhealth.direct.emds.com
  • Direct secure messaging: melting422934@direct-ehr-ssmhc.com

Organizations & group practices 4

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1841725918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-6000",
            "fax_number": "208-625-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267305",
            "telephone_number": "636-496-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTING",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M14507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Melting@famhealth.direct.emds.com",
            "affiliation": "N",
            "address_1": "914 W Ironwood Dr Ste 101",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838144927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.