Individual provider Active NPI

Andrew Zemcuznikov, LCSW

  • Clinical Social Worker
  • Creve Coeur, MO
National Provider Identifier
1649689837
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000129 Issued in MO
Practice address
11457 Olde Cabin Rd Ste 345
Creve Coeur, MO 63141
Phone
(314) 537-5035
Fax
(636) 517-1176
NPI assigned
Aug 13, 2014
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000129 MO Primary

Addresses

Primary practice location

11457 Olde Cabin Rd Ste 345
Creve Coeur, MO 63141

Mailing address

724 Spring Hill Farm Dr
Ballwin, MO 63021-8419
Phone (636) 225-3373

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141002001748 MO Practitioner - Clinical Social Worker 5092935601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 The Pines CT
Suite B
Saint Louis, MO 63141-6081
Phone (314) 537-5035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000129MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Zemcuznikov, LLC Clinical CurrentSince Apr 23, 2015 Accepting new patients

Locations

11457 Olde Cabin Rd
Ste 345
Saint Louis, MO 63141
Phone (314) 249-6813

3 The Pines Ct
Ste B
Saint Louis, MO 63141
Phone (314) 252-8434

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1649689837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 SPRING HILL FARM DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630218419",
            "telephone_number": "636-225-3373",
            "fax_number": "636-517-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11457 OLDE CABIN RD STE 345",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-537-5035",
            "fax_number": "636-517-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMCUZNIKOV",
        "first_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "000129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.