Individual provider Active NPI

Andrea Lui, M.D.

  • Family Medicine Physician
  • Creve Coeur, MO
National Provider Identifier
1780036491
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019035100 Issued in MO
Practice address
11770 Olive Blvd
Creve Coeur, MO 63141-7053
Phone
(314) 380-3014
Fax
(978) 645-6915
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.151306 IL
Family Medicine Physician 207Q00000X 149554 AK
Family Medicine Physician 207Q00000X MD-20722 HI
Family Medicine Physician 207Q00000X 2019035100 MO Primary

Addresses

Primary practice location

11770 Olive Blvd
Creve Coeur, MO 63141-7053

Mailing address

11770 Olive Blvd
Creve Coeur, MO 63141-7053
Phone (314) 380-3014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201028002745 TX Practitioner - Family Practice 4789977570 Reassigns benefits to 2 organizations
I20220406000788 MO Practitioner - Family Practice 4789977570 Reassigns benefits to 3 organizations
I20260223002051 IL Practitioner - Family Practice 4789977570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

99 Hawley LN
Suite 1102
Stratford, CT 06614-1211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-20722HIMDFamily Medicine Physician
036.151306ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation CurrentSince Oct 15, 2020 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Tapestry Telehealth PLLC CurrentSince Jan 13, 2026 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Oct 15, 2020 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

99 Hawley Ln
Ste 1102
Stratford, CT 06614

875 N Michigan Ave
Fl 31
Chicago, IL 60611
Phone (312) 794-7730

100 Chesterfield Business Pkwy
Fl 2
Chesterfield, MO 63005
Phone (314) 355-8585

Organizations & group practices 8

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1780036491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417053",
            "telephone_number": "314-380-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417053",
            "telephone_number": "314-380-3014",
            "fax_number": "978-645-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUI",
        "first_name": "ANDREA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.151306",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "149554",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-20722",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019035100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.