Individual provider Active NPI

Santiago Bo Plurad, D.O.

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1215902101
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R3J49 Issued in MO
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

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
R3J49MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.