NPIMap

Individual provider Active NPI

Felipe Eljaiek, M.D.

  • Internal Medicine Physician
  • Sullivan, MO
National Provider Identifier
1003927773
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
102270 Issued in MO
Practice address
101 Progress Pkwy
Sullivan, MO 63080-2359
Phone
(573) 468-3555
Fax
(573) 468-3554
NPI assigned
Aug 31, 2006
Last updated
Jan 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 102270 MO Primary

Addresses

Primary practice location

101 Progress Pkwy
Sullivan, MO 63080-2359

Mailing address

101 Progress Parkway
Sullivan, MO 63080
Phone (573) 468-3554

Other identifiers 2

IdentifierTypeStateIssuer
206677106MedicaidMO
P00430677OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070912000095 MO Practitioner - Internal Medicine 3173616778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

125 N Old Hwy 66
Bourbon, MO 65441-6298
Phone (573) 679-2006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
102270MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Internal Medicine Current Accepting new patients
Missouri Baptist Hospital of Sullivan CurrentSince Jan 1, 2008 Accepting new patients
Mercy Clinic East Communities CurrentSince Jul 1, 2012 Accepting new patients
Missouri Baptist Hospital of Sullivan CurrentSince Jan 1, 2008 Accepting new patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Missouri Baptist Hospital of Sullivan Past Accepting new patients
Missouri Baptist Hospital of Sullivan Past Accepting new patients
Sullivan Operations, LLC Past Accepting new patients
Missouri Baptist Hospital of Sullivan Past Accepting new patients

Locations

125 N Old Highway 66
Bourbon, MO 65441
Phone (573) 679-2006

9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100

875 N Commercial Ave
Saint Clair, MO 63077
Phone (636) 629-7467

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555

1326 S Service Rd W
#20
Sullivan, MO 63080
Phone (573) 468-3555

1326 S Service Rd W
Ste 20
Sullivan, MO 63080
Phone (573) 468-3555

751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343

965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

Networks

  • IL PPO Downstate
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: feljaiek283617@directc.mercy.net
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1003927773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROGRESS PARKWAY",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "63080",
            "telephone_number": "573-468-3554",
            "fax_number": "573-468-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROGRESS PKWY",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802359",
            "telephone_number": "573-468-3555",
            "fax_number": "573-468-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELJAIEK",
        "first_name": "FELIPE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "102270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206677106",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00430677",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, MO

Sources for this page

Verify at the official NPI Registry.