Active NPI
Laurence Perlstein
- Internal Medicine Physician
- Florissant, MO
National Provider Identifier
1407967474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- R2G11
- Practice address
- 1225 Graham Rd
Ste 2320C
Florissant, MO 63031-8012 - Phone
- (314) 831-6883
- Fax
- (314) 831-3716
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R2G11 | MO | Primary |
Addresses
Primary practice location
1225 Graham Rd
Ste 2320C
Florissant, MO 63031-8012
Mailing address
670 Mason Ridge Center Dr
Ste. 300
Saint Louis, MO 63141-8573
Phone (314) 831-6883
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208099713 | Medicaid | MO |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Internal Medicine | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1407967474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 MASON RIDGE CENTER DR",
"address_2": "STE. 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418573",
"telephone_number": "314-831-6883",
"fax_number": "314-831-3716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 GRAHAM RD",
"address_2": "STE 2320C",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630318012",
"telephone_number": "314-831-6883",
"fax_number": "314-831-3716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERLSTEIN",
"first_name": "LAURENCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "R2G11",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208099713",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.