| Washington University | |
|
4901 Forest Park Ave Saint Louis MO 63108 | |
| (314) 362-3937 | |
| (314) 362-3725 |
| Full Name | Washington University |
|---|---|
| Speciality | Clinic/Center |
| Location | 4901 Forest Park Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Cathy 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 7425 Forsyth Blvd Campus Box 8221 Saint Louis MO 63105-2171 Ph: (314) 935-0770 | Washington University 4901 Forest Park Ave Saint Louis MO 63108 Ph: (314) 362-3937 |
| NPI Number | 1013957562 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 08/15/2018 |
| Medicare PECOS PAC ID | 9830008770 |
|---|---|
| Medicare Enrollment ID | O20040607000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013957562 | NPI | - | NPPES |
| 08-01999 | Other | MO | UHC GROUP NUMBER |
| 552919508 | Medicaid | MO | |
| 0062375 | Other | MO | SPECIAL HEALTH CARE NEEDS |
| 610916400 | Other | MO | DEPARTMENT OF LABOR |
| 92215217 | Other | IL | BLUE SHIELD GROUP |
| 108RP6 | Other | MO | BLUE SHIELD BILLING CODE |
| 3697 | Other | MO | GHP MASTER VENDOR |
| 673341 | Other | MO | AETNA HMO GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Rajendra S Apte |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1528062411 PECOS PAC ID: 0648169201 Enrollment ID: I20040311001362 |
| Provider Name | Bryan Bowen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588660633 PECOS PAC ID: 5193710556 Enrollment ID: I20040416000310 |
| Provider Name | James R Hoekel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700804267 PECOS PAC ID: 8224002092 Enrollment ID: I20040826000012 |
| Provider Name | George J Harocopos |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1427074657 PECOS PAC ID: 5092774687 Enrollment ID: I20041008000429 |
| Provider Name | Robert E Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114918604 PECOS PAC ID: 5597716985 Enrollment ID: I20050420000441 |
| Provider Name | Kevin W Greuloch |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1285654616 PECOS PAC ID: 7911898986 Enrollment ID: I20050427000028 |
| Provider Name | Prabakar Rao |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1417959115 PECOS PAC ID: 2264328368 Enrollment ID: I20070514000134 |
| Provider Name | Jing-wei Huang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023194131 PECOS PAC ID: 4789779372 Enrollment ID: I20070927000244 |
| Provider Name | Gregory Paul Van Stavern |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134166051 PECOS PAC ID: 7113815036 Enrollment ID: I20090408000555 |
| Provider Name | John Thompson Lind |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1407054042 PECOS PAC ID: 0244307817 Enrollment ID: I20090728000837 |
| Provider Name | Nathan M Tuttle |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902034077 PECOS PAC ID: 8820134190 Enrollment ID: I20090930000568 |
| Provider Name | Eric E Polk |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184845422 PECOS PAC ID: 4385782051 Enrollment ID: I20091118000028 |
| Provider Name | Anjali K Pathak |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699791913 PECOS PAC ID: 4981745130 Enrollment ID: I20100109000217 |
| Provider Name | Mary K Lueckenhoff |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104842335 PECOS PAC ID: 7113068362 Enrollment ID: I20100109000260 |
| Provider Name | Michael A Kass |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1164440657 PECOS PAC ID: 3274632161 Enrollment ID: I20100109000266 |
| Provider Name | Richard H Wieder |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548288186 PECOS PAC ID: 7911048178 Enrollment ID: I20100109000297 |
| Provider Name | James B Shepherd |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1558389015 PECOS PAC ID: 3274674437 Enrollment ID: I20100109000305 |
| Provider Name | Philip Lynn Custer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1538187968 PECOS PAC ID: 0840332672 Enrollment ID: I20100116000243 |
| Provider Name | Mark Salvatore Rallo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700802931 PECOS PAC ID: 2567504392 Enrollment ID: I20100116000256 |
| Provider Name | Lawrence Tychsen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1568489094 PECOS PAC ID: 8820130651 Enrollment ID: I20100116000266 |
| Provider Name | Gregg Thomas Lueder |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1427076124 PECOS PAC ID: 6901948736 Enrollment ID: I20100116000276 |
| Provider Name | Anthony J Lubniewski |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1861418170 PECOS PAC ID: 2264574680 Enrollment ID: I20100123000241 |
| Provider Name | Carla J Siegfried |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457379133 PECOS PAC ID: 8224087002 Enrollment ID: I20100123000245 |
| Provider Name | Linda M Tsai |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1821014135 PECOS PAC ID: 0345382768 Enrollment ID: I20100123000249 |
| Provider Name | Susan M Culican |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1164440640 PECOS PAC ID: 8426189960 Enrollment ID: I20100628000860 |
| Provider Name | Steven M Couch |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1578590634 PECOS PAC ID: 3274634670 Enrollment ID: I20100714000127 |
| Provider Name | Mary C Blatt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437154499 PECOS PAC ID: 3678605284 Enrollment ID: I20100717000095 |
| Provider Name | David E Vollman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1225235104 PECOS PAC ID: 3173655792 Enrollment ID: I20100719000026 |
| Provider Name | Marisa A Obrien |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124332234 PECOS PAC ID: 8022201508 Enrollment ID: I20101015000829 |
| Provider Name | Joseph E Steska |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811128291 PECOS PAC ID: 6103015904 Enrollment ID: I20110110000614 |
| Provider Name | Rithwick Rajagopal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1679779912 PECOS PAC ID: 4486823200 Enrollment ID: I20110812000382 |
| Provider Name | Michelle K Beck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225322761 PECOS PAC ID: 5496925463 Enrollment ID: I20110830000562 |
| Provider Name | Navin Amin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1659353308 PECOS PAC ID: 0840342887 Enrollment ID: I20120110000828 |
| Provider Name | Sonya Bamba |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1679736359 PECOS PAC ID: 8527222975 Enrollment ID: I20120614000397 |
| Provider Name | Arsham Sheybani |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1487817995 PECOS PAC ID: 7517113202 Enrollment ID: I20120813000424 |
| Provider Name | Gabriel Burton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114272200 PECOS PAC ID: 8921257445 Enrollment ID: I20120927000111 |
| Provider Name | Mark R Barlow |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1710974183 PECOS PAC ID: 7012047863 Enrollment ID: I20130531000504 |
| Provider Name | Augustine R Hong |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730316449 PECOS PAC ID: 1355582362 Enrollment ID: I20130801000821 |
| Provider Name | Amanda M Nicklas |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639519481 PECOS PAC ID: 4284878265 Enrollment ID: I20130912000416 |
| Provider Name | Jordan K Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417235185 PECOS PAC ID: 7911179015 Enrollment ID: I20131023001107 |
| Provider Name | Todd P Margolis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1982719316 PECOS PAC ID: 4981788064 Enrollment ID: I20140207000658 |
| Provider Name | Sarah N Gore |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871922369 PECOS PAC ID: 6507184777 Enrollment ID: I20150420001099 |
| Provider Name | Bradley Shoss |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013203272 PECOS PAC ID: 1557673803 Enrollment ID: I20150630001025 |
| Provider Name | Kisha D Piggott |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1316236482 PECOS PAC ID: 6204065469 Enrollment ID: I20150716002354 |
| Provider Name | Michael Vincent Stock |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730442500 PECOS PAC ID: 9830328046 Enrollment ID: I20160726001141 |
| Provider Name | Emily Ann Gum |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780068395 PECOS PAC ID: 7315231974 Enrollment ID: I20160804002738 |
| Provider Name | Yevgeniy Vladimirovich Sychev |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1609166768 PECOS PAC ID: 2365763570 Enrollment ID: I20160817000344 |
| Provider Name | Angela J Demetrulias |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194013086 PECOS PAC ID: 3779740931 Enrollment ID: I20160826000288 |
| Provider Name | Zachary D Seagrave |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1043573280 PECOS PAC ID: 1759669203 Enrollment ID: I20161103001010 |
| Provider Name | Kyle Dale Dohrman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811275597 PECOS PAC ID: 9537322524 Enrollment ID: I20170202002246 |
| Provider Name | Albert Steven Li |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194068445 PECOS PAC ID: 2567730963 Enrollment ID: I20170607001628 |
| Provider Name | Jesse Theodore Himebaugh |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1073855243 PECOS PAC ID: 2062780059 Enrollment ID: I20170615001517 |
| Provider Name | Wesley C Green |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1851736037 PECOS PAC ID: 6406076850 Enrollment ID: I20170619001384 |
| Provider Name | Thomas Steven Shute |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1972737567 PECOS PAC ID: 4688819741 Enrollment ID: I20170623002247 |
| Provider Name | Fouad Fathi El Sayyad |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1396182242 PECOS PAC ID: 1759511892 Enrollment ID: I20170811001946 |
| Provider Name | Grace L Paley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184038986 PECOS PAC ID: 1759508419 Enrollment ID: I20180531001037 |
| Provider Name | Harris Chauhdry Sultan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1669890570 PECOS PAC ID: 4981966322 Enrollment ID: I20180531001042 |
| Provider Name | Margaret Mary Mcglynn Reynolds |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346656758 PECOS PAC ID: 4587881354 Enrollment ID: I20180601000675 |
| Provider Name | Robi Nicolas Maamari |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124438064 PECOS PAC ID: 1850656281 Enrollment ID: I20180605002642 |
| Provider Name | Bethany T Rosenthal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760973101 PECOS PAC ID: 7012272453 Enrollment ID: I20180605002791 |
| Provider Name | Alexander D Lin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346668506 PECOS PAC ID: 4183940448 Enrollment ID: I20180611000798 |
| Provider Name | Cynthia Lee Montana |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952721391 PECOS PAC ID: 3870849953 Enrollment ID: I20180703000235 |
| Provider Name | Brigid K Marshall |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083024855 PECOS PAC ID: 0840508123 Enrollment ID: I20180705001077 |
| Provider Name | Lilian Nguyen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1376958066 PECOS PAC ID: 7214284777 Enrollment ID: I20180716002236 |
| Provider Name | Igor Irvin Bussel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699193367 PECOS PAC ID: 4789986266 Enrollment ID: I20180720000779 |
| Provider Name | Daniel J Watson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871907378 PECOS PAC ID: 6305141649 Enrollment ID: I20180803000430 |
| Provider Name | Andrew Robert Lee |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992140958 PECOS PAC ID: 8921370677 Enrollment ID: I20180806000976 |
| Provider Name | Eric R Ricker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649797077 PECOS PAC ID: 6709135890 Enrollment ID: I20180822003812 |
| Provider Name | Lynn M Hassman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093158487 PECOS PAC ID: 2264669241 Enrollment ID: I20181026001223 |
| Provider Name | Erin G Sieck |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649664129 PECOS PAC ID: 2264743236 Enrollment ID: I20190618000156 |
| Provider Name | Julia Anne Pulliam |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245516350 PECOS PAC ID: 4880840693 Enrollment ID: I20190625001710 |
| Provider Name | Bliss Elizabeth O'bryhim |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1427439298 PECOS PAC ID: 7214230556 Enrollment ID: I20190626003909 |
| Provider Name | Richard Michael Schroeder |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1578957650 PECOS PAC ID: 3072847524 Enrollment ID: I20190703000457 |
| Provider Name | Michael Andrew Ullman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1750776076 PECOS PAC ID: 3678808607 Enrollment ID: I20190715000394 |
| Provider Name | James Chang Liu |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093101974 PECOS PAC ID: 5193037349 Enrollment ID: I20190718000275 |
| Provider Name | Leanne Stunkel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1588079107 PECOS PAC ID: 1153542188 Enrollment ID: I20190823000768 |
| Provider Name | Alexander Steven Barsam |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1578914974 PECOS PAC ID: 7719262252 Enrollment ID: I20200701001223 |
| Provider Name | Maxwell William Dixon |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093165490 PECOS PAC ID: 6709179872 Enrollment ID: I20200701001780 |
| Provider Name | Khin Pyaesone Kilgore |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1497119093 PECOS PAC ID: 3274823489 Enrollment ID: I20200706001832 |
| Provider Name | Jason Papas |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639533722 PECOS PAC ID: 6608161021 Enrollment ID: I20200724001233 |
| Provider Name | Eric L Sollenberger |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1518314350 PECOS PAC ID: 6709172224 Enrollment ID: I20200731001342 |
| Provider Name | Ross Matthew Kennamer-chapman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245765601 PECOS PAC ID: 3678972742 Enrollment ID: I20210521000291 |
| Provider Name | Jennifer Enright |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1477083236 PECOS PAC ID: 7810263977 Enrollment ID: I20210623001887 |
| Provider Name | Yunshuo Tang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1467972513 PECOS PAC ID: 6406127307 Enrollment ID: I20210712000730 |
| Provider Name | Tricia Ann Fernandez |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124551981 PECOS PAC ID: 6002161817 Enrollment ID: I20210723001123 |
| Provider Name | James Travis Walsh |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1306205703 PECOS PAC ID: 8921392630 Enrollment ID: I20210812000927 |
| Provider Name | Kalla A Gervasio |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1619409364 PECOS PAC ID: 1850642380 Enrollment ID: I20220613001061 |
| Provider Name | Karina Somohano |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1588169452 PECOS PAC ID: 6103162417 Enrollment ID: I20220621000265 |
| Provider Name | Douglas Snyder |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1891144697 PECOS PAC ID: 3072800895 Enrollment ID: I20220622000341 |
| Provider Name | Matthew C. Santos |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1295229342 PECOS PAC ID: 1153701552 Enrollment ID: I20220701000602 |
| Provider Name | Elizabeth Everson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558032102 PECOS PAC ID: 5294133617 Enrollment ID: I20220714000641 |
| Provider Name | Ashley Diane Ahlbrand |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215669007 PECOS PAC ID: 4284015538 Enrollment ID: I20220718001540 |
| Provider Name | Brent Steven Bruck |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1104310192 PECOS PAC ID: 1153703681 Enrollment ID: I20220801001383 |
| Provider Name | Huy Duy Nguyen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1578068623 PECOS PAC ID: 1951783307 Enrollment ID: I20220801002534 |
| Provider Name | Ariana Levin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1538666151 PECOS PAC ID: 3072946003 Enrollment ID: I20220804003583 |
| Provider Name | Lindsey Leigh Parrish Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518548122 PECOS PAC ID: 1850771643 Enrollment ID: I20230130001093 |
| Provider Name | Parth Shah |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1265937411 PECOS PAC ID: 9436489531 Enrollment ID: I20230213001400 |
| Provider Name | Jessica Yang Walia |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134625627 PECOS PAC ID: 4587995840 Enrollment ID: I20230314000253 |
| Provider Name | Mustafa Safi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1518325455 PECOS PAC ID: 3678933025 Enrollment ID: I20230717001561 |
| Provider Name | Giovanni Antonio Campagna |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1760942684 PECOS PAC ID: 4486015823 Enrollment ID: I20230801002355 |
| Provider Name | Viviana Barquet |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1568951853 PECOS PAC ID: 4082086723 Enrollment ID: I20230801002558 |
| Provider Name | Evan Austin Jameyfield |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184185670 PECOS PAC ID: 2668704735 Enrollment ID: I20230801004110 |
| Provider Name | Aaditya V Shah |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124688221 PECOS PAC ID: 1850627076 Enrollment ID: I20230803002445 |
| Provider Name | Nathaniel A Blecher |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1487215380 PECOS PAC ID: 7719213933 Enrollment ID: I20230803003291 |
| Provider Name | Praneetha Thulasi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1740546696 PECOS PAC ID: 0749574515 Enrollment ID: I20230803003630 |
| Provider Name | Katherine A Kindle |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1932668902 PECOS PAC ID: 3678806130 Enrollment ID: I20230829004013 |
| Provider Name | Alixandra Riddering |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1801356076 PECOS PAC ID: 0547624835 Enrollment ID: I20230920001070 |
| Provider Name | Kevin La |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407544166 PECOS PAC ID: 2961850771 Enrollment ID: I20231204002465 |
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 |