Mayank Agarwal, MD, MSE
Individual provider Active NPI Anesthesiology Physician · Saint Louis, MO
NPI 1083134134 · NPPES record last updated Mar 17, 2025
Key facts
- NPI
- 1083134134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 2019024485 (MO)
- Practice address
- 915 N Grand Blvd
Saint Louis, MO 63106-1621 - Phone
- (314) 652-4100
- NPI assigned
- Jun 20, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019024485 | MO | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2019024485 | MO | Yes |
Addresses
Primary practice location
915 N Grand Blvd
Saint Louis, MO 63106-1621
Mailing address
322 Willow Weald Path
Chesterfield, MO 63005-1297
Phone (636) 422-0007
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200062643 | Medicaid | MO |
Other providers in Saint Louis, MO
- Anubha Agarwal
- Anupam Agarwal
- Ashima Agarwal
- Gautum Agarwal
- Ishan Kumar Agarwal
- Shilpa M Agashe
- Oresta Agastra
- Tomilola Ayobami Agboola
- Ageless Health Care Inc
- Ankita Aggarwal
All providers in Saint Louis, MO · Anesthesiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.