Individual provider Active NPI

Edwardo Durante Verzola, M.D.

  • Gastroenterology Physician
  • Festus, MO
National Provider Identifier
1245381201
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2000161966 Issued in MO
Practice address
1400 US Highway 61
Suite 250
Festus, MO 63028-4100
Phone
(636) 937-8675
Fax
(636) 933-7981
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2000161966 MO Primary

Addresses

Primary practice location

1400 US Highway 61
Suite 250
Festus, MO 63028-4100

Mailing address

PO Box 127
1004 Industrial Drive
Herculaneum, MO 63048-0127
Phone (636) 937-8675

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
I20100125000392 MO Practitioner - Gastroenterology 0446256580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Missouri, Kansas City, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Gastroenterology LLCGroup PAC ID 8628121795, 66 clinicians

Practice addresses (Care Compare)

1390 US Hwy 61
Festus, MO 63028-4137
Phone (636) 937-8675

200 Brevco PLZ
Suite 208
Lake St Louis, MO 63367-2950
Phone (636) 561-9020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy76
Upper gastrointestinal (GI) endoscopy for acid reflux113

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Gastroenterology, LLC Gastroenterology CurrentSince Aug 3, 2015 Accepting new patients

Locations

1390 US Highway 61
Ste N1500
Crystal Cty, MO 63028
Phone (636) 933-5055

1400 US Highway 61
Ste 250
Crystal Cty, MO 63028
Phone (636) 543-2420

200 Brevco Plz
Ste 208
Lake St Louis, MO 63367
Phone (314) 251-3880

Interoperability endpoints

  • Direct secure messaging: everzola468838@directc.mercy.net

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1245381201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "address_2": "1004 INDUSTRIAL DRIVE",
            "city": "HERCULANEUM",
            "state": "MO",
            "postal_code": "630480127",
            "telephone_number": "636-937-8675",
            "fax_number": "636-933-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "address_2": "SUITE 250",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-937-8675",
            "fax_number": "636-933-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERZOLA",
        "first_name": "EDWARDO",
        "middle_name": "DURANTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2000161966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.