Dr Jorge Granadillo De Luque, MD is a medicare enrolled "Medical Genetics - Clinical Genetics (m.d.)" physician in Saint Louis, Missouri. He graduated from medical school in 2007 and has 17 years of diverse experience with area of expertise as Medical Genetics And Genomics. He is a member of the group practice Washington University and his current practice location is
1 Childrens Pl, Div Ped Genetics And Genomic Med, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 454-6093.
Dr Jorge Granadillo De Luque is licensed to practice in Missouri (license number 2017041051) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1952717902.
Physician's Profile
| Full Name | Dr Jorge Granadillo De Luque |
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| Gender | Male |
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| Speciality | Medical Genetics And Genomics |
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| Experience | 17 Years |
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| Location | 1 Childrens Pl, Saint Louis, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jorge Granadillo De Luque graduated from medical school in 2007
NPI Data:
- NPI Number: 1952717902
- Provider Enumeration Date: 07/09/2014
- Last Update Date: 05/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 0941556336
- Enrollment ID: I20180627000438
Medical Identifiers
Medical identifiers for Dr Jorge Granadillo De Luque such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1952717902 | NPI | - | NPPES |
| 200054630 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | 2017041051 (Missouri) | Secondary |
| 207SG0201X | Medical Genetics - Clinical Genetics (m.d.) | 2017041051 (Missouri) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Washington University | 9830008770 | 2516 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jorge Granadillo De Luque allows following entities to bill medicare on his behalf.
| Entity Name | Washington University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194765685
PECOS PAC ID: 9830008770
Enrollment ID: O20040607000287 |
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| Entity Name | The Curators Of The University Of Missouri |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235126921
PECOS PAC ID: 4486759560
Enrollment ID: O20070418000290 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jorge Granadillo De Luque is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Jorge Granadillo De Luque, MD
Po Box 60352,
Saint Louis, MO 63160-0352
Ph: (314) 454-6093 | Dr Jorge Granadillo De Luque, MD
1 Childrens Pl, Div Ped Genetics And Genomic Med,
Saint Louis, MO 63110-1002
Ph: (314) 454-6093 |
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