| Washington University, Department Of Surgery | |
|
660 S Euclid Ave Saint Louis MO 63110-1010 | |
| (314) 362-4964 | |
| (314) 747-4871 |
| Full Name | Washington University, Department Of Surgery |
|---|---|
| Speciality | Clinic/Center |
| Location | 660 S Euclid Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Cathy L Eghigian (DIRECTOR, CREDENTIALING OPERATIONS) |
| Authorized Official Contact | 3142730770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington University, Department Of Surgery 4240 Duncan Ave Suite 301 Saint Louis MO 63110-1123 Ph: (314) 273-0770 | Washington University, Department Of Surgery 660 S Euclid Ave Saint Louis MO 63110-1010 Ph: (314) 362-4964 |
| NPI Number | 1134169568 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 03/26/2015 |
| Medicare PECOS PAC ID | 9830008770 |
|---|---|
| Medicare Enrollment ID | O20040317000959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134169568 | NPI | - | NPPES |
| 610916400 | Other | MO | DEPARTMENT OF LABOR |
| 0425435 | Other | MO | SPECIAL HEALTH CARE NEEDS |
| 553061102 | Medicaid | MO | |
| 17-01999 | Other | MO | UHC GROUP NUMBER |
| 673341 | Other | MO | AETNA HMO GROUP |
| 3706 | Other | MO | GHP MASTER VENDOR |
| 92215227 | Other | IL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Douglas Schuerer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922024140 PECOS PAC ID: 8820980204 Enrollment ID: I20040329001427 |
| Provider Name | John E Mazuski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992723472 PECOS PAC ID: 8123910528 Enrollment ID: I20040329001571 |
| Provider Name | Craig Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962519785 PECOS PAC ID: 6406842749 Enrollment ID: I20040422000995 |
| Provider Name | Matthew G Mutch |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1669498887 PECOS PAC ID: 5991782799 Enrollment ID: I20040701000028 |
| Provider Name | William G Hawkins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538187257 PECOS PAC ID: 7214907500 Enrollment ID: I20040726001056 |
| Provider Name | Muhammad Yasin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205839404 PECOS PAC ID: 8628038155 Enrollment ID: I20041019000003 |
| Provider Name | Omar Guerra |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952337222 PECOS PAC ID: 9335109867 Enrollment ID: I20041019000019 |
| Provider Name | Jack Roh Oak |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1326269648 PECOS PAC ID: 2062477573 Enrollment ID: I20041124000066 |
| Provider Name | Jayme L Sparkman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730107376 PECOS PAC ID: 3274588579 Enrollment ID: I20050321000207 |
| Provider Name | William E Gillanders |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1720006364 PECOS PAC ID: 9032159603 Enrollment ID: I20050504000012 |
| Provider Name | Julie Margenthaler |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1750307054 PECOS PAC ID: 5799726113 Enrollment ID: I20050517000083 |
| Provider Name | Steven R Hunt |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1205853835 PECOS PAC ID: 1658314224 Enrollment ID: I20050606000008 |
| Provider Name | Jeffrey A Bailey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881664472 PECOS PAC ID: 3375574791 Enrollment ID: I20050825000700 |
| Provider Name | Jerry M Liddell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700872611 PECOS PAC ID: 7810929759 Enrollment ID: I20050831000541 |
| Provider Name | Ryan C Fields |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1912900440 PECOS PAC ID: 4284652447 Enrollment ID: I20051107000008 |
| Provider Name | John P Kirby |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902829823 PECOS PAC ID: 1759382112 Enrollment ID: I20070126000651 |
| Provider Name | Maria B Doyle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700903820 PECOS PAC ID: 1951405547 Enrollment ID: I20070410000060 |
| Provider Name | Jason Wellen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134331382 PECOS PAC ID: 9537268099 Enrollment ID: I20070625000063 |
| Provider Name | Carla S Robinson-rainey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689847873 PECOS PAC ID: 8224924014 Enrollment ID: I20080708000182 |
| Provider Name | Gregorio A Sicard |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1033135264 PECOS PAC ID: 6608760962 Enrollment ID: I20081002000125 |
| Provider Name | Katherine M Henslee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124282819 PECOS PAC ID: 7810055290 Enrollment ID: I20081029000619 |
| Provider Name | William C Chapman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790703270 PECOS PAC ID: 1658358148 Enrollment ID: I20081104000476 |
| Provider Name | Lawrence G Mendelow |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1811932502 PECOS PAC ID: 2567361520 Enrollment ID: I20090327000234 |
| Provider Name | Michael L Havenar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770723082 PECOS PAC ID: 2365590544 Enrollment ID: I20090427000455 |
| Provider Name | Michael M Awad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356495634 PECOS PAC ID: 5991850976 Enrollment ID: I20090826000674 |
| Provider Name | Luis A Sanchez |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1679590111 PECOS PAC ID: 5890837207 Enrollment ID: I20100123000119 |
| Provider Name | Bradley D Freeman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255359980 PECOS PAC ID: 2062554488 Enrollment ID: I20100123000151 |
| Provider Name | Michael David Weiss |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659354058 PECOS PAC ID: 2163319765 Enrollment ID: I20100201000688 |
| Provider Name | John C Eagon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801814538 PECOS PAC ID: 4082758636 Enrollment ID: I20100219000318 |
| Provider Name | Brian G Rubin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306877824 PECOS PAC ID: 9830233055 Enrollment ID: I20100225000369 |
| Provider Name | Surendra Shenoy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972521490 PECOS PAC ID: 2163566399 Enrollment ID: I20100225000414 |
| Provider Name | Patrick J Geraghty |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1376560821 PECOS PAC ID: 5395889554 Enrollment ID: I20100225000699 |
| Provider Name | Rebecca L Aft |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1164440897 PECOS PAC ID: 1850426123 Enrollment ID: I20100312000225 |
| Provider Name | Leslie M Brunt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992723621 PECOS PAC ID: 4789719345 Enrollment ID: I20100322000215 |
| Provider Name | Robert W Thompson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285652792 PECOS PAC ID: 9436287935 Enrollment ID: I20100504000264 |
| Provider Name | Todd J Neuberger |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1225098619 PECOS PAC ID: 9537298732 Enrollment ID: I20100526000915 |
| Provider Name | Heidi M Hunsel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194048686 PECOS PAC ID: 1153450994 Enrollment ID: I20100603000613 |
| Provider Name | Bruce L Hall |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1376560839 PECOS PAC ID: 9739210758 Enrollment ID: I20100708000051 |
| Provider Name | Timothy J Eberlein |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1225054455 PECOS PAC ID: 5294712782 Enrollment ID: I20100818000191 |
| Provider Name | Yiing Lin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922128891 PECOS PAC ID: 5991829640 Enrollment ID: I20100901000496 |
| Provider Name | Brent Allen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1770513319 PECOS PAC ID: 1254230212 Enrollment ID: I20100907000764 |
| Provider Name | Jeffrey E Zuke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386672608 PECOS PAC ID: 7618876673 Enrollment ID: I20100909000150 |
| Provider Name | Grant Bochicchio |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255388906 PECOS PAC ID: 9133311509 Enrollment ID: I20110801000788 |
| Provider Name | Julie P Colicchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962799668 PECOS PAC ID: 9638348097 Enrollment ID: I20110802000166 |
| Provider Name | Tiffany M Osborn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245438050 PECOS PAC ID: 3678521515 Enrollment ID: I20111119000037 |
| Provider Name | Amy L Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790050268 PECOS PAC ID: 7719140607 Enrollment ID: I20120511000102 |
| Provider Name | Melita C Ware |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891970364 PECOS PAC ID: 5496910747 Enrollment ID: I20120711000576 |
| Provider Name | Stephen R Eaton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013121243 PECOS PAC ID: 8022264217 Enrollment ID: I20120802000734 |
| Provider Name | Paul E Wise |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1619076056 PECOS PAC ID: 6901880699 Enrollment ID: I20120803000718 |
| Provider Name | Linda G Hornbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043477581 PECOS PAC ID: 4385894195 Enrollment ID: I20121031000648 |
| Provider Name | Kelly L Renfroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144598830 PECOS PAC ID: 9638322936 Enrollment ID: I20130118000088 |
| Provider Name | Dawn M Sander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265777106 PECOS PAC ID: 3375798895 Enrollment ID: I20130306000286 |
| Provider Name | Paula Lynn Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679823371 PECOS PAC ID: 7315183464 Enrollment ID: I20130417000076 |
| Provider Name | Dominic E Sanford |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013182120 PECOS PAC ID: 0547406225 Enrollment ID: I20130425000200 |
| Provider Name | Meaghan Anne Keeven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265771554 PECOS PAC ID: 0042457269 Enrollment ID: I20130507000673 |
| Provider Name | Matthew L Silviera |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1386805240 PECOS PAC ID: 6406097633 Enrollment ID: I20130730000692 |
| Provider Name | Sean C Glasgow |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1104912856 PECOS PAC ID: 7416095534 Enrollment ID: I20131030000324 |
| Provider Name | Shannon K Boles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760552665 PECOS PAC ID: 1052549847 Enrollment ID: I20140125000191 |
| Provider Name | Jamie L Anastas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174952089 PECOS PAC ID: 9133358799 Enrollment ID: I20140131001600 |
| Provider Name | Isaiah R Turnbull |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194975441 PECOS PAC ID: 7315176047 Enrollment ID: I20140520001977 |
| Provider Name | Sara A Buckman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124282157 PECOS PAC ID: 5294959193 Enrollment ID: I20140616002039 |
| Provider Name | Mohamed Adel Zayed |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1851525190 PECOS PAC ID: 4587889712 Enrollment ID: I20140702001038 |
| Provider Name | Nanette R Reed |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962479758 PECOS PAC ID: 3870515018 Enrollment ID: I20140731001403 |
| Provider Name | Nishant V Raj |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245473156 PECOS PAC ID: 5193945947 Enrollment ID: I20140930001811 |
| Provider Name | Emily B Gavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831500503 PECOS PAC ID: 8628299963 Enrollment ID: I20141029002439 |
| Provider Name | Obeid N Ilahi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225088891 PECOS PAC ID: 1456455518 Enrollment ID: I20141106001150 |
| Provider Name | Jeffrey Alan Blatnik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629266770 PECOS PAC ID: 3072751213 Enrollment ID: I20150811003362 |
| Provider Name | Christa E Sink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518376193 PECOS PAC ID: 3476860925 Enrollment ID: I20150915003147 |
| Provider Name | Jacqueline Anne Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891197000 PECOS PAC ID: 4981911427 Enrollment ID: I20150916002227 |
| Provider Name | Adeel S Khan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982822763 PECOS PAC ID: 7012186984 Enrollment ID: I20150929001364 |
| Provider Name | Laurie Jean Punch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013042100 PECOS PAC ID: 7719032192 Enrollment ID: I20160120002029 |
| Provider Name | Katherine Glover Collins |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1730316290 PECOS PAC ID: 6800114430 Enrollment ID: I20160218000364 |
| Provider Name | Maureen M Mercier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396101135 PECOS PAC ID: 7517262074 Enrollment ID: I20160219002009 |
| Provider Name | Shaina Rose Eckhouse |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164683025 PECOS PAC ID: 3072734599 Enrollment ID: I20160804001058 |
| Provider Name | Jason Snyder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447419320 PECOS PAC ID: 2860786852 Enrollment ID: I20160815001333 |
| Provider Name | Chet W Hammill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720283310 PECOS PAC ID: 2466506514 Enrollment ID: I20170308001950 |
| Provider Name | Leslie S Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144626896 PECOS PAC ID: 2264718279 Enrollment ID: I20170405001803 |
| Provider Name | Natalie K Meirink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174068456 PECOS PAC ID: 9436427382 Enrollment ID: I20170616001441 |
| Provider Name | John Westley Ohman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1093078115 PECOS PAC ID: 4789813163 Enrollment ID: I20170627002469 |
| Provider Name | Jennifer Yu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821351883 PECOS PAC ID: 5799054045 Enrollment ID: I20170630000502 |
| Provider Name | Chun-cheng Chen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073740890 PECOS PAC ID: 7810267408 Enrollment ID: I20170728001828 |
| Provider Name | Zachary P Englert |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306073614 PECOS PAC ID: 7113226374 Enrollment ID: I20170728002133 |
| Provider Name | Darren R Cullinan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033558192 PECOS PAC ID: 0648541094 Enrollment ID: I20170803003089 |
| Provider Name | Leslie A Beer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053784082 PECOS PAC ID: 1850663956 Enrollment ID: I20170824001843 |
| Provider Name | Kelly Vallar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033403589 PECOS PAC ID: 0648572008 Enrollment ID: I20170928002169 |
| Provider Name | Michelle L Medintz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063704070 PECOS PAC ID: 9234362971 Enrollment ID: I20170929000132 |
| Provider Name | Sara Holden |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730405812 PECOS PAC ID: 3678706850 Enrollment ID: I20171003007762 |
| Provider Name | Ashley N Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457882417 PECOS PAC ID: 6901174960 Enrollment ID: I20171229000401 |
| Provider Name | Radhika Smith |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1922310481 PECOS PAC ID: 2163701988 Enrollment ID: I20180306002101 |
| Provider Name | Sarah Ann Sotta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164913141 PECOS PAC ID: 9830446491 Enrollment ID: I20180727001766 |
| Provider Name | Bracken Abram Armstrong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730488396 PECOS PAC ID: 6406075852 Enrollment ID: I20180801003506 |
| Provider Name | Mark H Hoofnagle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033344759 PECOS PAC ID: 1254639552 Enrollment ID: I20180802002219 |
| Provider Name | Alyssa D Wait |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1659698058 PECOS PAC ID: 5395975171 Enrollment ID: I20180808000752 |
| Provider Name | Piroska Kopar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760601116 PECOS PAC ID: 4183932817 Enrollment ID: I20180808003866 |
| Provider Name | Jennifer Leonard |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619256641 PECOS PAC ID: 3678729696 Enrollment ID: I20180830003736 |
| Provider Name | Charlie Srivilasa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346531464 PECOS PAC ID: 9537421581 Enrollment ID: I20180912003300 |
| Provider Name | Jennifer Christine Raffaelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518409283 PECOS PAC ID: 9537410832 Enrollment ID: I20180926001233 |
| Provider Name | Heidi Molos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366926701 PECOS PAC ID: 3173877396 Enrollment ID: I20181106003114 |
| Provider Name | Stephanie E Clawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760733182 PECOS PAC ID: 2365788544 Enrollment ID: I20190109000051 |
| Provider Name | Tiffany R Anzalone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881153815 PECOS PAC ID: 1355683525 Enrollment ID: I20190509000222 |
| Provider Name | Vipul Khetarpaul |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1972730547 PECOS PAC ID: 4284863861 Enrollment ID: I20190715000128 |
| Provider Name | Arnab Majumder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144514423 PECOS PAC ID: 2466788419 Enrollment ID: I20190729001628 |
| Provider Name | Taylor Clarke Brown |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1770875478 PECOS PAC ID: 8123318649 Enrollment ID: I20190730002652 |
| Provider Name | Francesca Dimou |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649579889 PECOS PAC ID: 9436406725 Enrollment ID: I20190904000960 |
| Provider Name | Kathryn Marie Strope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245720846 PECOS PAC ID: 4183970957 Enrollment ID: I20190923002875 |
| Provider Name | Deacon J Lile |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558773473 PECOS PAC ID: 7012201353 Enrollment ID: I20191007003202 |
| Provider Name | Chelsea Hutchinson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083034284 PECOS PAC ID: 7416171251 Enrollment ID: I20191009000444 |
| Provider Name | Lauren Nicole Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003373200 PECOS PAC ID: 2365784980 Enrollment ID: I20191016002122 |
| Provider Name | Twinkle Kumar Pandian |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1649566928 PECOS PAC ID: 5092961912 Enrollment ID: I20200124001662 |
| Provider Name | Lauren Michelle Lutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174155337 PECOS PAC ID: 5092144923 Enrollment ID: I20200328000077 |
| Provider Name | Kelsey Elizabeth Ortmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265064703 PECOS PAC ID: 7416386099 Enrollment ID: I20200402000832 |
| Provider Name | Bethany Cara Sacks |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215084447 PECOS PAC ID: 3274505318 Enrollment ID: I20200803003380 |
| Provider Name | Natasha Leigh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275976201 PECOS PAC ID: 7517201155 Enrollment ID: I20200807000829 |
| Provider Name | Thoi Hieu Ngo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194139923 PECOS PAC ID: 9830515311 Enrollment ID: I20200813003807 |
| Provider Name | Nathan Michael Droz |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1083956494 PECOS PAC ID: 2860620010 Enrollment ID: I20200929000542 |
| Provider Name | Kerri A Ohman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457614570 PECOS PAC ID: 4789915653 Enrollment ID: I20210105001596 |
| Provider Name | Christine Frances Kuehnel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053906487 PECOS PAC ID: 0345657227 Enrollment ID: I20210319000715 |
| Provider Name | Jordan M Kirsch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376920538 PECOS PAC ID: 3375853070 Enrollment ID: I20210611002169 |
| Provider Name | Gregory R Martens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316201940 PECOS PAC ID: 5092952655 Enrollment ID: I20210707001906 |
| Provider Name | Jessica Kathryn Staszak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114360690 PECOS PAC ID: 9638316201 Enrollment ID: I20210715004143 |
| Provider Name | Zachary Wanken |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1215324413 PECOS PAC ID: 2860782679 Enrollment ID: I20210823001092 |
| Provider Name | Matthew J Mchale |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245431220 PECOS PAC ID: 6709020761 Enrollment ID: I20210909000153 |
| Provider Name | Lindsay Kranker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154748234 PECOS PAC ID: 1658593017 Enrollment ID: I20210915002051 |
| Provider Name | Mandy E Bettenhausen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295254266 PECOS PAC ID: 5294123212 Enrollment ID: I20211025002057 |
| Provider Name | Jennifer Marie Suszko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346912128 PECOS PAC ID: 5193113546 Enrollment ID: I20211104000147 |
| Provider Name | Kristin Alex Choate Engler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366109472 PECOS PAC ID: 7810388139 Enrollment ID: I20211221002505 |
| Provider Name | Michelle Alyson Cusumano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194477406 PECOS PAC ID: 3779979992 Enrollment ID: I20220414002166 |
| Provider Name | Neil Ermitano |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649620634 PECOS PAC ID: 0042541823 Enrollment ID: I20220506000662 |
| Provider Name | Patrick Craft |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740663368 PECOS PAC ID: 3870973340 Enrollment ID: I20220630002403 |
| Provider Name | Jesse Thornhill Davidson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881009835 PECOS PAC ID: 1658751987 Enrollment ID: I20220705002007 |
| Provider Name | Kaitlyn Kennard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518320662 PECOS PAC ID: 2567750839 Enrollment ID: I20220728002860 |
| Provider Name | Marguerite Winkler Spruce |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578943734 PECOS PAC ID: 0042613093 Enrollment ID: I20220808000763 |
| Provider Name | Genevieve Ann Hayek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679952048 PECOS PAC ID: 9638485378 Enrollment ID: I20220810000570 |
| Provider Name | Rami Al-aref |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033571229 PECOS PAC ID: 2264835222 Enrollment ID: I20220826000575 |
| Provider Name | Douglas J Cassidy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245619154 PECOS PAC ID: 5890001069 Enrollment ID: I20220909000140 |
| Provider Name | Brittany Dalia Greene |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093433120 PECOS PAC ID: 8325414287 Enrollment ID: I20221018000397 |
| Provider Name | Katherine Marie Holzem |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1861912529 PECOS PAC ID: 7911373626 Enrollment ID: I20221021000271 |
| Provider Name | Danange Marchell Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083383558 PECOS PAC ID: 8022485085 Enrollment ID: I20221103001326 |
| Provider Name | John Ackerman Olson |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1649370750 PECOS PAC ID: 6709920382 Enrollment ID: I20221116001022 |
| Provider Name | Teressa Lynn Swinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437871993 PECOS PAC ID: 3870962087 Enrollment ID: I20221210000437 |
| Provider Name | William Chapman |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1003297177 PECOS PAC ID: 3274847876 Enrollment ID: I20230606000999 |
| Provider Name | Brendan Paige Lovasik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538522990 PECOS PAC ID: 5890152920 Enrollment ID: I20230606001386 |
| Provider Name | Maggie Bosley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578067328 PECOS PAC ID: 7416207295 Enrollment ID: I20230622002449 |
| Provider Name | Candace Meagan Laplant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073219739 PECOS PAC ID: 6103284187 Enrollment ID: I20230623000377 |
| Provider Name | Jessica Lindemann |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386025237 PECOS PAC ID: 3971817164 Enrollment ID: I20230623002348 |
| Provider Name | Ashley Wilbers |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1801388608 PECOS PAC ID: 3375892094 Enrollment ID: I20230626000135 |
| Provider Name | Robert Matthew Macgregor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457701674 PECOS PAC ID: 6901264738 Enrollment ID: I20230626002878 |
| Provider Name | Nicholas Alan Welko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649711888 PECOS PAC ID: 5092062604 Enrollment ID: I20230703001370 |
| Provider Name | Matthew Randall Rosengart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316912751 PECOS PAC ID: 2264419928 Enrollment ID: I20230717002169 |
| Provider Name | Grace Martin Niziolek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528486339 PECOS PAC ID: 6406073600 Enrollment ID: I20230719003570 |
| Provider Name | Roheena Panni |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609280916 PECOS PAC ID: 0244691012 Enrollment ID: I20230727000505 |
| Provider Name | Savannah Kipfer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205376852 PECOS PAC ID: 1355619057 Enrollment ID: I20231127003153 |
| Provider Name | Eileen Ruggles Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194246314 PECOS PAC ID: 0749552586 Enrollment ID: I20231128000855 |
| Provider Name | Trang Kim Nguyen |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1275708653 PECOS PAC ID: 8820390313 Enrollment ID: I20240201001755 |
| Provider Name | Michelle Cowan |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1104129642 PECOS PAC ID: 2668692344 Enrollment ID: I20240411001933 |
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 |