Organization Active NPI

Cena Medical Group Inc

  • Nephrology Physician
  • Bridgeton, MO
National Provider Identifier
1457070385
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CENA MEDICAL GROUP INC
Practice address
3394 McKelvey Rd Ste 115
Bridgeton, MO 63044-2531
Phone
(314) 763-0589
Fax
(314) 405-9368
NPI assigned
Aug 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
David YuanNPI 1972552123
Title
Owner/MD
Phone
(314) 763-0589

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

3394 McKelvey Rd Ste 115
Bridgeton, MO 63044-2531

Mailing address

PO Box 411544
Saint Louis, MO 63141-3544
Phone (314) 763-0589

Other practice location 1

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 763-0589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221103000724 MO Part B Supplier - Clinic/Group Practice 5597132548 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO; Ellisville, MO; Arnold, MO; Bridgeton, MO; Creve Coeur, MO; Fenton, MO; Florissant, MO; Hazelwood, MO…

National Provider Directory

National Provider Directory

Locations

3394 McKelvey Rd
Ste 115
Bridgeton, MO 63044
Phone (314) 643-7692

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1457070385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411544",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631413544",
            "telephone_number": "314-763-0589",
            "fax_number": "314-405-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3394 MCKELVEY RD STE 115",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442531",
            "telephone_number": "314-763-0589",
            "fax_number": "314-405-9368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11133 Dunn Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366163",
            "country_code": "US",
            "telephone_number": "314-763-0589",
            "fax_number": "314-405-9368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "YUAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "314-763-0589"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.