Individual provider Active NPI

Lorena Buffa, MD

  • Pediatrics Physician
  • Saint Peters, MO
National Provider Identifier
1124092788
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2001009157 Issued in MO
Practice address
5301 Veterans Memorial Pkwy
Ste 104
Saint Peters, MO 63376-2298
Phone
(636) 939-3362
Fax
(636) 939-3687
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2001009157 MO Primary

Addresses

Primary practice location

5301 Veterans Memorial Pkwy
Ste 104
Saint Peters, MO 63376-2298

Mailing address

PO Box 7412025
Chicago, IL 60674-2025
Phone (636) 939-3362

Other identifiers 1

IdentifierTypeStateIssuer
205288707MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20050307000003 MO Practitioner - Pediatric Medicine 6002860715 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001009157MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wuca - Cloverleaf Pediatrics, LLC Pediatrics CurrentSince May 3, 2015 Accepting new patients
Mercy Clinic East Communities Pediatrics Past Accepting new patients

Locations

5301 Veterans Memorial Pkwy
Ste 104
Saint Peters, MO 63376
Phone (636) 561-0871

4200 N Cloverleaf Dr
Ste F
Saint Peters, MO 63376
Phone (636) 939-3362

Interoperability endpoints

  • Direct secure messaging: lbuffa134110@direct.carenet.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1124092788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412025",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742025",
            "telephone_number": "636-939-3362",
            "fax_number": "636-939-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 VETERANS MEMORIAL PKWY",
            "address_2": "STE 104",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762298",
            "telephone_number": "636-939-3362",
            "fax_number": "636-939-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFFA",
        "first_name": "LORENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2001009157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205288707",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "5301 Veterans Memorial Pkwy",
            "address_2": "STE 104",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633762298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.