Delene Prenita Musielak, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2019012317 Issued in MO

Practice address

8857B Ladue Rd
Saint Louis, MO 63124-2058

Phone

(314) 682-3626

Fax

(314) 590-5954

NPI assigned

Jul 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Delene Prenita Etwaru Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: delene.musielak.1@27880.direct.athenahealth.com
• Direct secure messaging: delene.musielak@670794513055748.direct.elationemr.com

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.

• Creve Coeur Family Medicine, LLC

  • Family Medicine Physician
  • Creve Coeur, MO
  • NPI 1801146766
  Medicare reassignment NPD
• Alea Health and Wellness LLC

  • Multi-Specialty Clinic/Center
  • Chesterfield, MO
  • NPI 1528776341
  NPD
• St. Lukes Medical Group

  • Family Medicine Physician
  • Chesterfield, MO
  • NPI 1215308945

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1033348057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8857B LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242058",
            "telephone_number": "146-823-6263",
            "fax_number": "314-590-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8857B LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242058",
            "telephone_number": "314-682-3626",
            "fax_number": "314-590-5954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11550 Olive Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Creve Coeur",
            "state": "MO",
            "postal_code": "631417111",
            "country_code": "US",
            "telephone_number": "314-523-2590",
            "fax_number": "314-523-2592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSIELAK",
        "first_name": "DELENE",
        "middle_name": "PRENITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-12",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "46271",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2019012317",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2019012317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-GA",
            "identifier": "1033348057",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003159470A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELENE",
            "last_name": "ETWARU",
            "middle_name": "PRENITA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Admir Music
• Thomas F Musich, M.D.
• Brittany Nicole Musick, OTR
• Amy C Musiek, MD
• Erik Steven Musiek, MD
• Amjad Musleh, MD
• Anthony J Muslin, MD
• Melinda C Musselman, RD
• Robin Musselman, N.P.
• Esed Mustafic

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.