Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Paul J Diesfeld, PA-C

Individual provider Physician Assistant · NPI 1396796041

Paul J Diesfeld, PA-C is a Physician Assistant in Bridgeton, Missouri. Qualified in 1996, 30 years ago. Practices with SSM Medical Group Inc, a 560-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
30
Licensed in
MO
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

12349 De Paul Dr Ste 100
Bridgeton, MO 63044-2512
Phone: (314) 291-3399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12266 Depaul Drive, Bridgeton, MO 63044 — (314) 291-3399

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 119779 (MO)

Record details

NPI number1396796041
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 15, 2006
Last updated in NPPESOctober 21, 2020
Certification dateOctober 21, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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