Individual provider Active NPI

Andrew Scaduto, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1659367704
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9931 Issued in MO
Practice address
8112 Delmar Blvd
Saint Louis, MO 63130-3736
Phone
(314) 546-5808
Fax
(314) 677-6807
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R9931 MO Primary

Addresses

Primary practice location

8112 Delmar Blvd
Saint Louis, MO 63130-3736

Mailing address

PO Box 240244
Ballwin, MO 63024-0244
Phone (314) 546-5808

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
I20070130000686 MO Practitioner - Family Practice 2062452378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R9931MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirpa LLC Past Accepting new patients
Vpa PC Family Medicine PastSince Apr 28, 2024 Accepting new patients
Simran Behavioral Health Past Accepting new patients
Nineveh Home Health Services LLC Family Medicine PastSince Nov 17, 2024 Accepting new patients
Healthcare Physicians of Southern Illinois, PC Family Medicine Past Accepting new patients
Choice Group, LLC Past Accepting new patients
Institute for Research and Education in Family Medicine Family Medicine PastSince Dec 17, 2023 Accepting new patients
County of St Louis Division of Fiscal Management Past Accepting new patients
Vpa PC Family Medicine Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nineveh HospiceSaint Charles, MO, CCN 261715 Hospice Contracted Managing Employee (25%) Nov 17, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1659367704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240244",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630240244",
            "telephone_number": "314-546-5808",
            "fax_number": "314-677-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631303736",
            "telephone_number": "314-546-5808",
            "fax_number": "314-677-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCADUTO",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.