Active NPI
Naresh Misir
- Internal Medicine Physician
- Florissant, MO
National Provider Identifier
1639280902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 103679
- Practice address
- 1225 Graham Rd
Ste C1340
Florissant, MO 63031-8012 - Phone
- (314) 831-6737
- Fax
- (314) 831-9269
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 103679 | MO | Primary |
Addresses
Primary practice location
1225 Graham Rd
Ste C1340
Florissant, MO 63031-8012
Mailing address
670 Mason Ridge Center Dr
Ste. 300
Saint Louis, MO 63141-8573
Phone (314) 831-6737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203777206 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180510001577 | FL | Order and Referring Only - General Practice | 4385726157 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103679 | MO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1639280902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 MASON RIDGE CENTER DR",
"address_2": "STE. 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418573",
"telephone_number": "314-831-6737",
"fax_number": "314-831-9269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 GRAHAM RD",
"address_2": "STE C1340",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630318012",
"telephone_number": "314-831-6737",
"fax_number": "314-831-9269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISIR",
"first_name": "NARESH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "103679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203777206",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
- William John Miller, DMD
- Kendall Ann Milnor
- Mindgarden Play Therapy and Consulting LLC
- Antonesha Debroah Minor
- Davin Minor, PHARMD
- Missouri CVS Pharmacy LLC (CVS Pharmacy# 06745)
- Missouri CVS Pharmacy LLC (CVS Pharmacy# 10355)
- Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy # 10171)
- Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #18047)
- Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #18000)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.