NPIMap

Organization Active NPI

Mysorekar Surgical

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1003231002
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
108329 Issued in MO
Legal business name
MYSOREKAR SURGICAL
Practice address
8342 Delcrest Dr
Apt 303
Saint Louis, MO 63124-2100
Phone
(314) 359-5648
NPI assigned
Feb 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rajeev Nagaraj Mysorekar, M.D.
Title
Manager
Phone
(314) 359-5648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 108329 MO Primary

Addresses

Primary practice location

8342 Delcrest Dr
Apt 303
Saint Louis, MO 63124-2100

Mailing address

8342 Delcrest Dr
Apt 303
Saint Louis, MO 63124-2100
Phone (314) 359-5648

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1003231002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8342 DELCREST DR",
            "address_2": "APT 303",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242100",
            "telephone_number": "314-359-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8342 DELCREST DR",
            "address_2": "APT 303",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242100",
            "telephone_number": "314-359-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSOREKAR SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "MYSOREKAR",
        "authorized_official_first_name": "RAJEEV",
        "authorized_official_middle_name": "NAGARAJ",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "314-359-5648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "108329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.