Anita Chacko, MD

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

R4F01 Issued in MO

Practice address

621 S New Ballas Rd
Ste. 674a
Saint Louis, MO 63141-8232

Phone

(314) 251-6831

Fax

(314) 251-5670

NPI assigned

Dec 21, 2005

Sex

Female

Sole proprietor

Yes

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

Practice roles

Interoperability endpoints

• Direct secure messaging: achacko100313@directc.mercy.net

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.

• Mercy Clinic Children'S Infectious Disease, LLC

  • Pediatric Infectious Diseases Physician
  • Saint Louis, MO
  • NPI 1518274489
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1417933433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "STE. 674A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6831",
            "fax_number": "314-251-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "STE. 674A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6831",
            "fax_number": "314-251-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACKO",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "MO",
            "license": "R4F01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE #",
            "identifier": "R4F01",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Chabloz
• Michael Chabot, DO
• Catherine Chackes
• Jessica Ashley Chackes, DPT
• Anisha Sarah Chacko, MD
• Neviya Rose Chacko, DPT
• Ruth Chacko, M.D.
• Sonia Chacko, M.D.
• Lauren Elizabeth Chacon, LCSW
• Rajagopal V Chadaga, MD

• Pediatric Infectious Diseases Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Infectious Diseases Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.