Active NPI
Mark Coelho, C-AA
- Anesthesiologist Assistant
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- Practice address
- 615 S New Ballas Rd
Saint Louis, MO 63141-8221 - Phone
- (636) 386-9224
- Fax
- (636) 386-7679
- NPI assigned
- Feb 12, 2021
- Last updated
- May 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiologist Assistant | 367H00000X | MO | Primary |
Addresses
Primary practice location
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Mailing address
339 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 386-9224
Other practice location 1
5323 Honey Ct
Ellicott City, MD 21043-8205
Phone (443) 360-8278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, DC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Medstar Medical Group Anesthesiology LLC | Current | Accepting new patients | |
| Medstar Medical Group Anesthesiology LLC | Current | Accepting new patients |
Locations
110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000
2000 15th St N
Ste 600
Arlington, VA 22201
Phone (703) 558-1217
Organizations & group practices 4
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.
-
dba MMG Anesthesiology LLC
- Anesthesiology Physician
- Baltimore, MD
- NPI 1528578333
DC
-
dba Western Anesthesiology Pain Management
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1275646754
-
- Anesthesiology Physician
- Washington, DC
- NPI 1558976175
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Washington, DC
- NPI 1548378235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1750974473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 CONSORT DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630114439",
"telephone_number": "636-386-9224",
"fax_number": "636-386-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S NEW BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418221",
"telephone_number": "636-386-9224",
"fax_number": "636-386-7679"
}
],
"practiceLocations": [
{
"address_1": "5323 Honey Ct",
"address_purpose": "LOCATION",
"city": "Ellicott City",
"state": "MD",
"postal_code": "210438205",
"country_code": "US",
"telephone_number": "443-360-8278",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COELHO",
"first_name": "MARK",
"credential": "C-AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-12",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "MO",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.