NPIMap

Individual provider Active NPI

Enquan Gao, M.D.

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1295051548
Registry record updated Jul 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2014009032 Issued in MO
Practice address
815 Renee LN
Saint Louis, MO 63141-7642
Phone
(314) 933-6142
NPI assigned
Apr 12, 2010
Last updated
Jul 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2014009032 MO Primary
Psychiatry Physician 2084P0800X 036134609 IL

Addresses

Primary practice location

815 Renee LN
Saint Louis, MO 63141-7642

Mailing address

815 Renee LN
Saint Louis, MO 63141-7642
Phone (314) 933-6142

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140714000586 MO Practitioner - PsychiatryPractitioner - Neurology 0446475198 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians
Mercy Clinic Adult Hospitalists Jefferson LLCGroup PAC ID 8628205598, 58 clinicians
Mercy Clinic Adult Hospitalists - St. Louis, LLCGroup PAC ID 6002809944, 139 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1899

10018 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-3423

10412 Litzsinger Rd
Saint Louis, MO 63131-3500
Phone (314) 251-0555

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-8091

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036134609ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Aco Clinical Services Inc CurrentSince Jan 15, 2024 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Jul 1, 2020 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Oct 1, 2020 Accepting new patients
Mercy East Support Services, LLC CurrentSince Aug 18, 2014 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Jul 1, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC CurrentSince Jul 1, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Jul 1, 2020 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients
Mercy Hospital South Past Accepting new patients
Mercy Hospital Joplin Past Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

Interoperability endpoints

  • Direct secure messaging: enquan.gao.1@20454.direct.athenahealth.com

Organizations & group practices 11

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405209600000",
    "number": "1295051548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 RENEE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417642",
            "telephone_number": "314-933-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 RENEE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417642",
            "telephone_number": "314-933-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "ENQUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-12",
        "last_updated": "2014-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2014009032",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036134609",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.