| Mercy East Support Services, Llc | |
|
615 S New Ballas Rd Admin Building 5th Floor Saint Louis MO 63141-8221 | |
| (314) 251-6000 | |
| Not Available |
| Full Name | Mercy East Support Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 615 S New Ballas Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Donn E. Sorensen (PRESIDENT-EAST COMMUNITIES) |
| Authorized Official Contact | 3142511565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy East Support Services, Llc 615 S New Ballas Rd Admin Building 5th Floor Saint Louis MO 63141-8221 Ph: (314) 251-6000 | Mercy East Support Services, Llc 615 S New Ballas Rd Admin Building 5th Floor Saint Louis MO 63141-8221 Ph: (314) 251-6000 |
| NPI Number | 1225382013 |
|---|---|
| Provider Enumeration Date | 11/01/2012 |
| Last Update Date | 11/01/2012 |
| Medicare PECOS PAC ID | 0446498729 |
|---|---|
| Medicare Enrollment ID | O20130528000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225382013 | NPI | - | NPPES |
| Provider Name | Laishang P Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235143942 PECOS PAC ID: 7719974682 Enrollment ID: I20040430000804 |
| Provider Name | Mohammad Asif Qaisrani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245250968 PECOS PAC ID: 6103877923 Enrollment ID: I20050209000122 |
| Provider Name | Carolyn M Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669465134 PECOS PAC ID: 8325080880 Enrollment ID: I20050525000030 |
| Provider Name | Malik I Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770557985 PECOS PAC ID: 5294752648 Enrollment ID: I20051026000073 |
| Provider Name | Sue A Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164459772 PECOS PAC ID: 5294749990 Enrollment ID: I20060202000117 |
| Provider Name | Sofia Grewal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265441299 PECOS PAC ID: 2860490760 Enrollment ID: I20061130000359 |
| Provider Name | Heide A Rodgers |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164577300 PECOS PAC ID: 6305948399 Enrollment ID: I20070222000002 |
| Provider Name | Laurence J Kinsella |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770591646 PECOS PAC ID: 6608906995 Enrollment ID: I20100614000096 |
| Provider Name | Eduardo Luis Garcia-ferrer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619917101 PECOS PAC ID: 8820128077 Enrollment ID: I20100614000814 |
| Provider Name | Cynthia Renee Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881908986 PECOS PAC ID: 9234254830 Enrollment ID: I20100920001018 |
| Provider Name | John F Mantovani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528163904 PECOS PAC ID: 5799932588 Enrollment ID: I20120830000145 |
| Provider Name | Gina M Bufe |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1326381765 PECOS PAC ID: 7517108384 Enrollment ID: I20130722000346 |
| Provider Name | Pooja Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578728218 PECOS PAC ID: 3870736242 Enrollment ID: I20130904000466 |
| Provider Name | Matthew Charles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770913089 PECOS PAC ID: 4486884129 Enrollment ID: I20140225002284 |
| Provider Name | Enquan Gao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295051548 PECOS PAC ID: 0446475198 Enrollment ID: I20140714000586 |
| Provider Name | Bethany Sleckman |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1861814386 PECOS PAC ID: 1153541438 Enrollment ID: I20141009000054 |
| Provider Name | Rohit R Pawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013237122 PECOS PAC ID: 8022321587 Enrollment ID: I20150714000133 |
| Provider Name | Pravesh Prabhu Deotale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710275110 PECOS PAC ID: 2163660283 Enrollment ID: I20160708000233 |
| Provider Name | Michael Farell Massa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598825382 PECOS PAC ID: 6901899277 Enrollment ID: I20180411002139 |
| Provider Name | Mara Kathleen Trautman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922543958 PECOS PAC ID: 5294017463 Enrollment ID: I20180725003522 |
| Provider Name | Rada Helen Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508397910 PECOS PAC ID: 7517292311 Enrollment ID: I20190716003738 |
| Provider Name | Melody Kay Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336604370 PECOS PAC ID: 3375871510 Enrollment ID: I20190826001874 |
| Provider Name | Shelah Radke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366695967 PECOS PAC ID: 8426386319 Enrollment ID: I20190830001285 |
| Provider Name | Kathryn Shemwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700263506 PECOS PAC ID: 0749582542 Enrollment ID: I20191007000249 |
| Provider Name | Uyen Quynh Kim Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770124745 PECOS PAC ID: 7911330428 Enrollment ID: I20191213000522 |
| Provider Name | Bamidele Ganiyu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073155933 PECOS PAC ID: 1153759394 Enrollment ID: I20200320002762 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
Town And Country Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 | |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 | |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 | |
Victus Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 | |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
Dtg Ii Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3819 Tesson Ct, Saint Louis, MO 63123 Phone: 800-268-7713 Fax: 415-704-3294 |