Individual provider Active NPI

Naresh J Solanki, M.D.

  • Pediatric Adolescent Medicine Physician
  • Lake St Louis, MO
National Provider Identifier
1225007412
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
R2A26 Issued in MO
Practice address
100 Brevco PLZ
Suite 101
Lake St Louis, MO 63367-1392
Phone
(636) 561-5437
Fax
(636) 561-5100
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X R2A26 MO Primary

Addresses

Primary practice location

100 Brevco PLZ
Suite 101
Lake St Louis, MO 63367-1392

Mailing address

100 Brevco PLZ
Suite 101
Lake St Louis, MO 63367-1392
Phone (636) 561-5437

Other identifiers 10

IdentifierTypeStateIssuer
201171634MedicaidMO
100957OtherMOHEALTHLINK
8630OtherMOGROUP HEALTH PLAN
1209358OtherMOUNITED HEALTH CARE
409446OtherMOPRUDENTIAL
7890OtherMOBLUE SHIELD
PC11413OtherMOCIGNA
500012OtherMOHEALTH PARTNERS
5758046OtherMOAETNA
F28413OtherMOMERCY HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170324002053 MO Practitioner - Pediatric Medicine 3476838905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2A26MOMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wuca-Westside Pediatrics LLC CurrentSince Apr 1, 2017 Accepting new patients
Naresh Solanki Inc Adolescent Medicine PastSince Apr 1, 2017 Accepting new patients

Locations

100 Brevco Plz
Ste 101
Lake St Louis, MO 63367
Phone (636) 561-5100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1225007412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREVCO PLZ",
            "address_2": "SUITE 101",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671392",
            "telephone_number": "636-561-5437",
            "fax_number": "636-561-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREVCO PLZ",
            "address_2": "SUITE 101",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671392",
            "telephone_number": "636-561-5437",
            "fax_number": "636-561-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLANKI",
        "first_name": "NARESH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "R2A26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201171634",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "100957",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "8630",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1209358",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUDENTIAL",
            "identifier": "409446",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "7890",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PC11413",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "500012",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5758046",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN",
            "identifier": "F28413",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.