Individual provider Active NPI

Patricia Ann Dettenmeier, MSN CS

  • Critical Care Medicine Registered Nurse
  • St Louis, MO
National Provider Identifier
1861460180
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
78947 Issued in MO
Practice address
3660 Vista
St Louis, MO 63110
Phone
(314) 977-6190
Fax
(314) 268-5108
NPI assigned
Mar 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 78947 MO Primary
Medical-Surgical Registered Nurse 163WM0705X 78947 MO
Adult Health Nurse Practitioner 363LA2200X 78947 MO

Addresses

Primary practice location

3660 Vista
St Louis, MO 63110

Mailing address

3691 Rutger Ave
Provider Enrollment
St Louis, MO 63110
Phone (314) 977-4440

Other names 1

  • Patricia Wittman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100605000232 MO Practitioner - Nurse Practitioner 7315077195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

3545 Lafayette Ave
Suite 1200
Saint Louis, MO 63104-1314
Phone (314) 977-5337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
78947MOMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

3545 Lafayette Ave
Ste 1200
Saint Louis, MO 63104
Phone (314) 977-5337

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: pdettenmeier21164@direct-ehr-ssmhc.com

Organizations & group practices 3

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 4

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": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1861460180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3691 RUTGER AVE",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-977-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 VISTA",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-977-6190",
            "fax_number": "314-268-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTENMEIER",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "MSN CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "78947",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MO",
            "license": "78947",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "78947",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "WITTMAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Louis, MO

Sources for this page

Verify at the official NPI Registry.