Enrique Pastrana, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R1P02 Issued in MO

Practice address

1011 Bowles Ave.
Suite 300
Fenton, MO 63026-2387

Phone

(636) 496-5030

Fax

(636) 496-5035

NPI assigned

Aug 24, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1417940412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE.",
            "address_2": "SUITE 300",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "631222387",
            "telephone_number": "636-496-5030",
            "fax_number": "636-496-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE.",
            "address_2": "SUITE 300",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262387",
            "telephone_number": "636-496-5030",
            "fax_number": "636-496-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTRANA",
        "first_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "R1P02",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208176503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pranav R Parikh, M.D.
• Kristina S Park, PHARMD
• Julie M. Parker, PT
• Karissa Parrish, RN
• Pasia Medical Rehabilitation, LLC
• Aman Kanti Patel, DO
• Patients First Health Care LLC
• Rachel Pence
• Gregorius Resuma Penilla, M.D.
• Timothy James Perkins, MSN, FNP-BC

• Surgery Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Surgery Physician in Missouri

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