Active NPI
Sukanti Raikar, M.D.
- Internal Medicine Physician
- Creve Coeur, MO
National Provider Identifier
1609299023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036.063732
- Practice address
- 920 Bellerive Manor Dr
Creve Coeur, MO 63141-6094 - Phone
- (314) 434-6841
- NPI assigned
- Jan 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036.063732 | IL | Primary |
Addresses
Primary practice location
920 Bellerive Manor Dr
Creve Coeur, MO 63141-6094
Mailing address
920 Bellerive Manor Dr
Creve Coeur, MO 63141-6094
Phone (314) 434-6841
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.063732 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1609299023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 BELLERIVE MANOR DR",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631416094",
"telephone_number": "314-434-6841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 BELLERIVE MANOR DR",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631416094",
"telephone_number": "314-434-6841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIKAR",
"first_name": "SUKANTI",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-22",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.063732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.