NPIMap

Individual provider Active NPI

Andrew Micah Grabowski, DO

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1093714917
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003019557 Issued in MO
Practice address
4438 Telegraph Rd
Saint Louis, MO 63129-3316
Phone
(314) 543-5996
Fax
(314) 543-5958
NPI assigned
Jul 21, 2005
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2003019557 MO Primary

Addresses

Primary practice location

4438 Telegraph Rd
Saint Louis, MO 63129-3316

Mailing address

4438 Telegraph Rd
Saint Louis, MO 63129-3316
Phone (314) 543-5996

Other identifiers 2

IdentifierTypeStateIssuer
924975688OtherMOMEDICARE PTAN #
209278019MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000095 MO Practitioner - Family Practice 2567410145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

5758 Telegraph Rd
Oakville, MO 63129-4244
Phone (314) 543-5996

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

4438 Telegraph Rd
Saint Louis, MO 63129
Phone (314) 543-5996

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Interoperability endpoints

  • Direct secure messaging: agrabowski992392@directc.mercy.net

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1093714917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4438 TELEGRAPH RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293316",
            "telephone_number": "314-543-5996",
            "fax_number": "314-543-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 TELEGRAPH RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293316",
            "telephone_number": "314-543-5996",
            "fax_number": "314-543-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABOWSKI",
        "first_name": "ANDREW",
        "middle_name": "MICAH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003019557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "924975688",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209278019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.