Individual provider Active NPI

Michael J Zerega, MD

  • Gastroenterology Physician
  • Lake St Louis, MO
National Provider Identifier
1073505178
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2000154596 Issued in MO
Practice address
200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2949
Phone
(636) 561-9020
Fax
(636) 561-6208
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2000154596 MO Primary

Addresses

Primary practice location

200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2949

Mailing address

200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2949
Phone (636) 561-9020

Other identifiers 3

IdentifierTypeStateIssuer
1073505178MedicaidMO
P01015409OtherMORAILROAD MEDICARE
18943OtherBC BS MO

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
I20051215000647 MO Practitioner - Gastroenterology 0042231250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Gastroenterology LLCGroup PAC ID 8628121795, 66 clinicians

Practice addresses (Care Compare)

200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2950
Phone (636) 561-9020

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-2880

901 Patients 1St Dr
Suite 3300
Washington, MO 63090-4700
Phone (636) 239-7344

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy81
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Gastroenterology, LLC Gastroenterology CurrentSince Dec 1, 2011 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 1, 2016 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 1, 2016 Accepting new patients
Digestive Disease Medical Consultants, PC Gastroenterology PastSince Jan 1, 2006 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

226 S Woods Mill Rd
Ste 52W
Chesterfield, MO 63017
Phone (314) 434-2399

200 Brevco Plz
Ste 208
Lake St Louis, MO 63367
Phone (314) 251-3880

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

615 S New Ballas Rd
Ste 1200
Saint Louis, MO 63141
Phone (314) 251-2880

3023 N Ballas Rd
Ste 520D
Saint Louis, MO 63131
Phone (314) 569-2620

Interoperability endpoints

  • Direct secure messaging: mzerega223317@directc.mercy.net

Organizations & group practices 5

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

Hospital & facility affiliations 5

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1073505178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BREVCO PLZ",
            "address_2": "SUITE 208",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672949",
            "telephone_number": "636-561-9020",
            "fax_number": "636-561-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BREVCO PLZ",
            "address_2": "SUITE 208",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672949",
            "telephone_number": "636-561-9020",
            "fax_number": "636-561-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEREGA",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2000154596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073505178",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01015409",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS MO",
            "identifier": "18943",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.