Active NPI
Santiago Bo Plurad, D.O.
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1215902101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R3J49
- Practice address
- 3915 Watson Rd
Suite 202
Saint Louis, MO 63109-1251 - Phone
- (314) 781-7415
- Fax
- (314) 644-4592
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R3J49 | MO | Primary |
Addresses
Primary practice location
3915 Watson Rd
Suite 202
Saint Louis, MO 63109-1251
Mailing address
3915 Watson Rd
Suite 202
Saint Louis, MO 63109-1251
Phone (314) 781-7415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3J49 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St. Louis | Past | Accepting new patients | |
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- splurad1116@directc.mercy.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SSM Health St. Joseph Hospital - St. Charles Physician Billing
- Emergency Medicine Physician
- Saint Charles, MO
- NPI 1427002922
Pediatrics
-
dba SSM Health St. Clare Hospital - Fenton
- General Acute Care Hospital
- Fenton, MO
- NPI 1851496152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318809600000",
"number": "1215902101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 WATSON RD",
"address_2": "SUITE 202",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631091251",
"telephone_number": "314-781-7415",
"fax_number": "314-644-4592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 WATSON RD",
"address_2": "SUITE 202",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631091251",
"telephone_number": "314-781-7415",
"fax_number": "314-644-4592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLURAD",
"first_name": "SANTIAGO",
"middle_name": "BO",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2011-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R3J49",
"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 Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.