Active NPI
Vanessa Mondestin, M.D.
- Pediatrics Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA10558700
- Practice address
- 1 Childrens PL
3S34
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6006
- Fax
- (314) 454-4102
- NPI assigned
- Jun 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA10558700 | NJ | Primary |
| Pediatrics Physician | 208000000X | 2016021E05 | MO |
Addresses
Primary practice location
1 Childrens PL
3S34
Saint Louis, MO 63110-1002
Mailing address
1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016021E05 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capital Health Multispecialty Group | Current | Accepting new patients | |
| Emergency Physician Associates of North Jersey P C | Current | Accepting new patients | |
| Robert Wood Johnson University Hospital, Inc | Past | Accepting new patients | |
| Capital Health System, Inc. | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200
3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661
1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000
99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232
750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/5bb47b8f-8587-42a0-80df-8d4eecf69db3/
Organizations & group practices 5
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.
-
- Surgery Physician
- Trenton, NJ
- NPI 1083072342
-
- Emergency Medicine Physician
- Summit, NJ
- NPI 1497783419
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
dba Capital Health Medical Center - Hopewell
- General Acute Care Hospital
- Pennington, NJ
- NPI 1073516183
-
- General Acute Care Hospital
- New Brunswick, NJ
- NPI 1346243375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1144671868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CAPITAL WAY",
"city": "PENNINGTON",
"state": "NJ",
"postal_code": "085342520",
"telephone_number": "609-303-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "3S34",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6006",
"fax_number": "314-454-4102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONDESTIN",
"first_name": "VANESSA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-23",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA10558700",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2016021E05",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.