Individual provider Active NPI

Gerald Lionelli, M.D.

  • Plastic Surgery Physician
  • Chesterfield, MO
National Provider Identifier
1336258177
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
2002010427 Issued in MO
Practice address
224 S Woods Mill Rd
Suite 450 South
Chesterfield, MO 63017-3513
Phone
(314) 843-0900
Fax
(314) 843-0904
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 2002010427 MO Primary

Addresses

Primary practice location

224 S Woods Mill Rd
Suite 450 South
Chesterfield, MO 63017-3513

Mailing address

PO Box 419074
Creve Coeur, MO 63141-9074
Phone (314) 843-0900

Other identifiers 1

IdentifierTypeStateIssuer
200001907MedicaidMO

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Diagnostic Center LLC Past Accepting new patients
Plastic Surgery Consultants, LTD. Plastic Surgery PastSince Jun 27, 2021 Accepting new patients

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1336258177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419074",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631419074",
            "telephone_number": "314-843-0900",
            "fax_number": "314-843-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD",
            "address_2": "SUITE 450 SOUTH",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173513",
            "telephone_number": "314-843-0900",
            "fax_number": "314-843-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIONELLI",
        "first_name": "GERALD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MO",
            "license": "2002010427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200001907",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.