Individual provider Active NPI

Pavithra Saikumar

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1861985053
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
94-09600 Issued in KY
Practice address
One Grand Boulevard
St. Louis, MO 63103-3124
Phone
(512) 998-3001
NPI assigned
Jun 12, 2018
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 94-09600 KY Primary

Addresses

Primary practice location

One Grand Boulevard
St. Louis, MO 63103-3124

Mailing address

One Grand Boulevard
St. Louis, MO 63103-3124
Phone (512) 998-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240902000007 WA Practitioner - Pediatric Medicine 3072862481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

200 Lilly Rd NE
Suite C
Olympia, WA 98506-5080
Phone (360) 933-0368

311 S L St
Tacoma, WA 98405-3720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-09600KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Pediatrics CurrentSince Aug 8, 2024 Accepting new patients
Multicare Health System CurrentSince Aug 8, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

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.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1861985053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GRAND BOULEVARD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631033124",
            "telephone_number": "512-998-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GRAND BOULEVARD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631033124",
            "telephone_number": "512-998-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAIKUMAR",
        "first_name": "PAVITHRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-08-17",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "94-09600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.