Individual provider Active NPI

Sunita Dharmavarapu, MD

  • Anesthesiology Physician
  • O'Fallon, MO
National Provider Identifier
1063542793
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2003004999 Issued in MO
Practice address
2 Progress Point CT
O Fallon, MO 63368-2208
Phone
(314) 286-1050
Fax
(314) 344-1138
NPI assigned
Mar 6, 2007
Last updated
Jul 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2003004999 MO Primary

Addresses

Primary practice location

2 Progress Point CT
O Fallon, MO 63368-2208

Mailing address

660 S Euclid Ave
C B 8054
Saint Louis, MO 63110-1010
Phone (314) 286-1050

Other identifiers 1

IdentifierTypeStateIssuer
321903447MedicaidIL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031222000865 MO Practitioner - Anesthesiology 5092613463 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia Services of St. Charles, LLC Anesthesiology CurrentSince Jan 7, 2008 Accepting new patients
Midwest Anesthesia Inc. Anesthesiology Past Accepting new patients
University Anesthesia Services, PLLC Anesthesiology Past Accepting new patients

Locations

4203 S Cloverleaf Dr
Saint Peters, MO 63376
Phone (636) 346-6051

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1063542793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-286-1050",
            "fax_number": "314-344-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PROGRESS POINT CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682208",
            "telephone_number": "314-286-1050",
            "fax_number": "314-344-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARMAVARAPU",
        "first_name": "SUNITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2003004999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321903447",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.