Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Henry Charles Ideker, MD

Individual provider Otolaryngology Physician · NPI 1063973972

Henry Charles Ideker, MD is an Otolaryngology in St. Louis, Missouri. Graduated from University of Texas Medical Branch at Galveston in 2019, 7 years ago. Practices with SSM Health Care Group, a 923-clinician group and accepts Medicare assignment. Licensed in Missouri and Pennsylvania.

Years since qualifying
7
Trained at
University of Texas Medical Branch at Galveston
Licensed in
MO, PA
In the registry since
2019
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1225 S Grand Blvd Garden Level Door 3
St. Louis, MO 63104
Phone: (314) 577-8884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 2025029856 (MO)
Otolaryngology Physician Taxonomy 207Y00000X · Licence MT231592 (PA)
Sleep Medicine (Otolaryngology) Physician Taxonomy 207YS0012X · Licence MT231592 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063973972
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 26, 2019
Last updated in NPPESAugust 7, 2025
Certification dateAugust 7, 2025
Mailing address1008 S Spring Ave Ste 3300, Saint Louis, MO 63110-2520

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 2019 (7 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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