Individual provider Active NPI

Sudhir R Raikar, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Maryland Heights, MO
National Provider Identifier
1124013487
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
R8500 Issued in MO
Practice address
83 Progress Pkwy
Maryland Heights, MO 63043-3701
Phone
(314) 434-8174
Fax
(314) 434-8706
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X R8500 MO Primary

Addresses

Primary practice location

83 Progress Pkwy
Maryland Heights, MO 63043-3701

Mailing address

920 Bellerive Manor Dr
Creve Coeur, MO 63141-6094
Phone (314) 434-6841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Aug 15, 2021 Accepting new patients
North County Emergency Physicians, LLP Past Accepting new patients
Our Urgent Care, LLC PastSince Dec 9, 2019 Accepting new patients

Locations

1111 W Pearce Blvd
Wentzville, MO 63385
Phone (636) 856-5362

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1124013487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 BELLERIVE MANOR DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416094",
            "telephone_number": "314-434-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 PROGRESS PKWY",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433701",
            "telephone_number": "314-434-8174",
            "fax_number": "314-434-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIKAR",
        "first_name": "SUDHIR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "R8500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryland Heights, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.