Brian K Dieckgraefe, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

R3M46 Issued in MO

Practice address

4921 Parkview PL
8TH Floor Suite C
Saint Louis, MO 63110-1032

Phone

(314) 454-8200

Fax

(314) 362-8230

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1295751428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8124",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-454-8200",
            "fax_number": "314-362-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "8TH FLOOR SUITE C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-454-8200",
            "fax_number": "314-362-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKGRAEFE",
        "first_name": "BRIAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "R3M46",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206755415",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Dicus, LCSW
• Susan A. Didier, M.S.W., L.C.S.W.
• Karlene Didion, FNP
• Umer Aman Dido, PHARMACIST
• Valle Anne Diebold
• Sherilyn Dieckhaus
• Elizabeth Diehl, M.D.
• Karen Diehl, CPNP
• Morgan Diehl, PLPC
• Sharon Kathleen Diekemper, RN LPC MED

• Gastroenterology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.