Missouri Endocrine & Diabetes Center, Inc.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MDR1G71 Issued in MO

Legal business name

MISSOURI ENDOCRINE & DIABETES CENTER, INC.

Practice address

12401 Olive Blvd
Suite 207
Saint Louis, MO 63141-5448

Phone

(636) 878-5530

Fax

(314) 878-2434

NPI assigned

Mar 12, 2009

Last updated

Oct 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amin Radparvar, MDNPI 1316987837

Title

Owner

Phone

(636) 939-9004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amin Radparvar, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Peters, MO
  • NPI 1316987837
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1487895074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "address_2": "SUITE 207",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "636-878-5530",
            "fax_number": "314-878-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "address_2": "SUITE 207",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "636-878-5530",
            "fax_number": "314-878-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI ENDOCRINE & DIABETES CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "RADPARVAR",
        "authorized_official_first_name": "AMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-939-9004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "MDR1G71",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Endocrinology, Diabetes & Metabolism Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.