Irwin Plisco, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R8E05 Issued in MO

Practice address

1224 Graham Rd
Suite 2003
Florissant, MO 63031-8028

Phone

(314) 839-4554

Fax

(314) 837-0047

NPI assigned

Nov 9, 2005

Last updated

Dec 8, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Integra Physicians Urgent Care Centers, LLC

  dba Des Peres Urgent Care Center

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1740319284
  NPD (past) Authorized official

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1871574525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-839-4554",
            "fax_number": "314-837-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 GRAHAM RD",
            "address_2": "SUITE 2003",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318028",
            "telephone_number": "314-839-4554",
            "fax_number": "314-837-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLISCO",
        "first_name": "IRWIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R8E05",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "24734",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "127484",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0400525",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "102101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4040631",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6400",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCLUSIVE CHOICE",
            "identifier": "C04130",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000010029",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE ST CHARLES",
            "identifier": "000000012461",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US",
            "identifier": "2267138",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "A10442",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Platinum Healthcare in Home Services LLC
• Platinum Healthcare Living Services LLC
• Platinum Home Healthcare, LLC
• Pleasant Journey Mobile Lab
• Carrie Lee Plisco, WHNP, AGPCNP
• Donovan C Polack, MD
• Roseline Omolola Popoola, BS
• John A Powers, PNP
• Precious Palms in-Home Services LLC
• Predictive Needs Healthcare Services LLC

• Internal Medicine Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.