NPIMap

Organization Active NPI

Wuca-Westside Pediatrics LLC

  • Pediatrics Physician
  • Lake St Louis, MO
National Provider Identifier
1700325123
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WUCA-WESTSIDE PEDIATRICS LLC
Practice address
100 Brevco PLZ
Suite 101
Lake St Louis, MO 63367-1382
Phone
(636) 561-5437
Fax
(636) 561-5100
NPI assigned
Feb 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Ms. Cathy Eghigian
Title
Senior Director Wu Managed Care
Phone
(618) 791-0975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

100 Brevco PLZ
Suite 101
Lake St Louis, MO 63367-1382

Mailing address

PO Box 7412119
Chicago, IL 60674-2011
Phone (636) 561-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170323002293 MO Part B Supplier - Clinic/Group Practice 6507141074 Receives reassigned benefits from 4 practitioners
Practice locations: Lake St Louis, MO

National Provider Directory

National Provider Directory

Locations

100 Brevco Plz
Lake Saint Louis, MO 63367

100 Brevco Plz
Ste 101
Lake St Louis, MO 63367
Phone (636) 561-5100

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1700325123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412119",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "636-561-5437",
            "fax_number": "636-561-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREVCO PLZ",
            "address_2": "SUITE 101",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671382",
            "telephone_number": "636-561-5437",
            "fax_number": "636-561-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WUCA-WESTSIDE PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "EGHIGIAN",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR WU MANAGED CARE",
        "authorized_official_telephone_number": "618-791-0975",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.