Individual provider Active NPI

Valerie T. Taca, MD

  • Internal Medicine Physician
  • Creve Coeur, MO
National Provider Identifier
1740331735
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2010035683 Issued in MO
Practice address
228 Carlyle Lake Dr
Creve Coeur, MO 63141-7544
Phone
(314) 583-3237
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2010035683 MO Primary

Addresses

Primary practice location

228 Carlyle Lake Dr
Creve Coeur, MO 63141-7544

Mailing address

228 Carlyle Lake Dr
Creve Coeur, MO 63141-7544
Phone (314) 583-3237

Other names 1

  • Dr. Valerie T. Tiong Former name

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
I20110203000874 MO Practitioner - Internal Medicine 7618073297 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Saint Peters, MO 63376-1659
Phone (800) 501-9855

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

Hospital & facility affiliations

  • Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010035683MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Aug 16, 2017 Accepting new patients
SSM Health Care St Louis CurrentSince Jun 1, 2019 Accepting new patients
Dr. Petre I Anguelinin, LLC Internal Medicine CurrentSince Feb 1, 2020 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Aug 24, 2018 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1740331735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 CARLYLE LAKE DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417544",
            "telephone_number": "314-583-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 CARLYLE LAKE DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417544",
            "telephone_number": "314-583-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACA",
        "first_name": "VALERIE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2010035683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "TIONG",
            "middle_name": "T.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.