Individual provider Active NPI

Laurence Perlstein

  • Internal Medicine Physician
  • Florissant, MO
National Provider Identifier
1407967474
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R2G11 Issued in MO
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

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
208099713MedicaidMO

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
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.

Verify at the official NPI Registry.