Individual provider Active NPI

Avrohom Levy, DO

  • Student in an Organized Health Care Education/Training Program
  • Saint Louis, MO
National Provider Identifier
1134878200
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 577-5600
NPI assigned
Mar 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MO
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

8368 Delmar Blvd Apt 1N
Saint Louis, MO 63124-2151
Phone (718) 549-9106

Other practice location 1

1945 State Route 33
Neptune, NJ 07753-4859
Phone (732) 775-5500

Other practice location 2

530 New Brunswick Ave
Perth Amboy, NJ 08861-3685
Phone (732) 442-3700

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
I20250830000104 MO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9234630211

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1134878200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8368 DELMAR BLVD APT 1N",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242151",
            "telephone_number": "718-549-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 State Route 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-775-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 New Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088613685",
            "country_code": "US",
            "telephone_number": "732-442-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVY",
        "first_name": "AVROHOM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.