Organization Active NPI

Elite Surgical Assisting LLC

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1154793248
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ELITE SURGICAL ASSISTING LLC
Practice address
2355 Dougherty Ferry Rd Ste 430
Saint Louis, MO 63122-3325
Phone
(888) 826-4546
Fax
(888) 826-4546
NPI assigned
Oct 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Authorized official

Name
Dr. Darin M. Minkin, D.O.NPI 1043296494
Title
Administrator
Phone
(314) 965-8622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 163WR0006X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2355 Dougherty Ferry Rd Ste 430
Saint Louis, MO 63122-3325

Mailing address

PO Box 323
New Melle, MO 63365-0323
Phone (888) 826-4546

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1154793248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 323",
            "city": "NEW MELLE",
            "state": "MO",
            "postal_code": "633650323",
            "telephone_number": "888-826-4546",
            "fax_number": "888-826-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 DOUGHERTY FERRY RD STE 430",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223325",
            "telephone_number": "888-826-4546",
            "fax_number": "888-826-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "MINKIN",
        "authorized_official_first_name": "DARIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-965-8622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Dec 7, 2018; 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.