Active NPI
Michael J Brischetto, MD
- Pulmonary Disease Physician
- Saint Louis, MO
National Provider Identifier
1780656058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- R3C38
- Practice address
- 621 S New Ballas Rd
Suite 483a
Saint Louis, MO 63141-8232 - Phone
- (314) 251-4966
- NPI assigned
- Feb 2, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | R3C38 | MO | Primary |
Addresses
Primary practice location
621 S New Ballas Rd
Suite 483a
Saint Louis, MO 63141-8232
Mailing address
621 S New Ballas Rd
Suite 228-a
Saint Louis, MO 63141-8232
Phone (314) 251-4966
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290014698 | Other | MO | RAILROAD MEDICARE |
| 201863800 | Medicaid | MO | |
| P00925264 | Other | MO | RAILROAD MEDICARE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Support Services | Past | Accepting new patients | |
| St. John's Mercy Support Services | Past | Accepting new patients |
Interoperability endpoints
- mbrischetto75401@directc.mercy.net
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Washington, MO
- NPI 1912020397
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1780656058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS RD",
"address_2": "SUITE 228-A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418232",
"telephone_number": "314-251-4966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS RD",
"address_2": "SUITE 483A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418232",
"telephone_number": "314-251-4966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISCHETTO",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MO",
"license": "R3C38",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "290014698",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201863800",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00925264",
"state": "MO"
}
],
"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 Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.