Michel John Adonis, M.D.
Individual provider Active NPI Pediatrics Physician · Saint Louis, MO
NPI 1497190854 · NPPES record last updated Feb 22, 2023
Key facts
- NPI
- 1497190854
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 2018005742 (MO)
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104 - Phone
- (314) 268-4095
- NPI assigned
- Apr 29, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180716000954 | MO | Practitioner - Pediatric Medicine | 5991096380 | Reassigns benefits to 4 organizations |
| I20180727001371 | IL | Practitioner - Pediatric Medicine | 5991096380 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018005742 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current |
Accepting new patients |
| SSM Health Care St Louis | Current |
Accepting new patients | |
| Phelps County Regional Medical Center | Current |
Accepting new patients | |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current |
Accepting new patients |
| Phelps County Regional Medical Center | Current |
Accepting new patients | |
| Pcrmc Medical Group, Inc | Pediatrics | Current |
Accepting new patients |
| SSM Health Care St. Louis | Current |
Accepting new patients | |
| SSM Cardinal Glennon Children'S Hospital | Pediatrics | Current |
Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189
Interoperability endpoints
- madonis278998@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | Q8195 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 2018005742 | MO | Yes |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 268-4095
Other practice location 1
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other practice location 2
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000
Other providers in Saint Louis, MO
- Jill Marie Adlon
- Administrative Support Services, Inc
- Administrative Support Services, Inc
- Jacob Charles Adney
- Nana Adofo-Ansong
- Adore Home Care LLC
- Adore Home Healthcare, LLC
- Adore Personal Care LLC
- Adore You Transportation Services LLC
- Michelle Susan Adorjan
All providers in Saint Louis, MO · Pediatrics Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.