Active NPI
Sandra D Duarte-Sckell, M.D.
- Psychiatry Physician
- Saint Louis, MO
National Provider Identifier
1720105281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2010027261
- Practice address
- 3535 S Jefferson Ave Ste 118
Saint Louis, MO 63118-3907 - Phone
- (314) 776-7999
- Fax
- (314) 772-2257
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2004018041 | MO | |
| Psychiatry Physician | 2084P0800X | 046068 | CT | |
| Psychiatry Physician | 2084P0800X | MD12964 | RI | |
| Psychiatry Physician | 2084P0800X | 2010027261 | MO | Primary |
Addresses
Primary practice location
3535 S Jefferson Ave Ste 118
Saint Louis, MO 63118-3907
Mailing address
1063 Fruit Tree LN
Saint Louis, MO 63146-4514
Phone (314) 898-8750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD75901 | Medicaid | RI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046068 | CT | MD | Psychiatry Physician |
| 2004018041 | MO | MD | Psychiatry Physician |
| 2010027261 | MO | MD | Psychiatry Physician |
| MD12964 | RI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1720105281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1063 FRUIT TREE LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631464514",
"telephone_number": "314-898-8750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 S JEFFERSON AVE STE 118",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631183907",
"telephone_number": "314-776-7999",
"fax_number": "314-772-2257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE-SCKELL",
"first_name": "SANDRA",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2004018041",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "046068",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "MD12964",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2010027261",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD75901",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.