Individual provider Active NPI

Eric H Mai, MD

  • Family Medicine Physician
  • Creve Coeur, MO
National Provider Identifier
1477520583
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2002005132 Issued in MO
Practice address
11445 Olive Blvd
Creve Coeur, MO 63141-7108
Phone
(314) 428-9543
Fax
(636) 326-6110
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2002005132 MO Primary

Addresses

Primary practice location

11445 Olive Blvd
Creve Coeur, MO 63141-7108

Mailing address

11445 Olive Blvd
Creve Coeur, MO 63141-7108
Phone (314) 428-9543

Other practice location 1

714 Gravois Rd
Suite 100
Fenton, MO 63026-7723
Phone (636) 326-6100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080107000513 MO Practitioner - Family Practice 3173603982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

11445 Olive Blvd
Creve Coeur, MO 63141-7108
Phone (314) 428-9543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2002005132MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheen Vein Institute Inc CurrentSince Mar 1, 2020 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Jun 19, 2022 Accepting new patients
American Multispecialty Group Inc. Family Medicine PastSince Aug 4, 2009 Accepting new patients
Mercy Clinic East Communities Family Medicine Past Accepting new patients

Locations

714 Gravois Rd
Ste 100
Fenton, MO 63026
Phone (636) 326-6100

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

11445 Olive Blvd
Saint Louis, MO 63141
Phone (314) 428-9543

11144 Tesson Ferry Rd
Ste 100
Saint Louis, MO 63123
Phone (314) 842-1441

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 5

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1477520583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11445 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417108",
            "telephone_number": "314-428-9543",
            "fax_number": "636-326-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417108",
            "telephone_number": "314-428-9543",
            "fax_number": "636-326-6110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "714 Gravois Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630267723",
            "country_code": "US",
            "telephone_number": "636-326-6100",
            "fax_number": "636-326-6110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAI",
        "first_name": "ERIC",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2002005132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.