Individual provider Active NPI

Gita J. Malur, M.D.

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1578698924
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-086181 Issued in IL
Practice address
5701 Delmar Blvd
Saint Louis, MO 63112-2617
Phone
(314) 367-7848
Fax
(314) 367-2985
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-086181 IL Primary

Addresses

Primary practice location

5701 Delmar Blvd
Saint Louis, MO 63112-2617

Mailing address

5701 Delmar Blvd
Saint Louis, MO 63112-2617
Phone (314) 367-7848

Other identifiers 1

IdentifierTypeStateIssuer
036086181MedicaidIL

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
I20161102000232 MO Practitioner - Pediatric Medicine 5092765610 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-086181ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Betty Jean Kerr People'S Health Centers CurrentSince Dec 1, 2016 Accepting new patients
Betty Jean Kerr People'S Health Centers CurrentSince Dec 1, 2016 Accepting new patients
Pediatric Healthcare Unlimited Pediatrics Past Accepting new patients

Locations

5701 Delmar Blvd
Saint Louis, MO 63112
Phone 31436778481248

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2511/brand/1/csg/1/fhir/r4
  • Direct secure messaging: gita.malur@direct.phcenters.nextgenshare.com

Organizations & group practices 3

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1578698924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122617",
            "telephone_number": "314-367-7848",
            "fax_number": "314-367-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122617",
            "telephone_number": "314-367-7848",
            "fax_number": "314-367-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALUR",
        "first_name": "GITA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-086181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086181",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.