Adriana M Canas-Polesel, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2004022976 Issued in MO

Practice address

1203 Smizer Mill Rd Ste 106
Fenton, MO 63026-3483

Phone

(636) 717-1390

Fax

(636) 717-1395

NPI assigned

Jan 26, 2006

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Practice roles

Interoperability endpoints

• Direct secure messaging: acanaspolesel105353@directc.mercy.net
• Direct secure messaging: acanaspolesel1228@direct-ehr-ssmhc.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.

• SSM Health Care St Louis

  dba SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment
• Excel Care OB GYN Inc

  • Obstetrics & Gynecology Physician
  • Crystal City, MO
  • NPI 1457321846
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1083684468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 SMIZER MILL RD STE 106",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263483",
            "telephone_number": "636-717-1390",
            "fax_number": "636-717-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 SMIZER MILL RD STE 106",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263483",
            "telephone_number": "636-717-1390",
            "fax_number": "636-717-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAS-POLESEL",
        "first_name": "ADRIANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2004022976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208785600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Joseph Calandro, D.C.
• Molly Ann Calandro, LMT
• Tanner George Calvert, PHARMD
• Cambridge Medical for Men LLC
• Cambridge Medical, LLC
• Mirranda Cardinali
• Tiffany Carey, COTA/L
• William Carpenter, DC
• Nicholas Paul Carper, M.D., M.P.H.
• Ariana Paulina Carrillo-Jones

• Obstetrics & Gynecology Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.