Shigemasa Ikeda, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

R5870 Issued in MO

Practice address

3635 Vista Ave. at Grand Blvd
Dept. Anesthesiology & Critical Care, Sluh
St. Louis, MO 63110-0250

Phone

(314) 577-8750

NPI assigned

Apr 29, 2009

Last updated

Apr 29, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1144464546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 CHESHIRE FARM CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418502",
            "telephone_number": "314-434-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE. AT GRAND BLVD",
            "address_2": "DEPT. ANESTHESIOLOGY & CRITICAL CARE, SLUH",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631100250",
            "telephone_number": "314-577-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDA",
        "first_name": "SHIGEMASA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "R5870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clement Barieenee Ika
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• Summer Dawn Ilcken, CCC-SLP
• Genevieve Ille

• Anesthesiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.