Active NPI
Mauro Alcala Paez, M.D.
- Clinical Medical Laboratory
- O'Fallon, MO
National Provider Identifier
1871830885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 2007000648
- Practice address
- 923 Midpoint Dr
O Fallon, MO 63366-5906 - Phone
- (636) 875-3157
- NPI assigned
- Jan 10, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 2007000648 | MO | Primary |
Addresses
Primary practice location
923 Midpoint Dr
O Fallon, MO 63366-5906
Mailing address
923 Midpoint Dr
O Fallon, MO 63366-5906
Phone (636) 875-3157
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007000648 | MO | MD | Clinical Medical Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1871830885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "923 MIDPOINT DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633665906",
"telephone_number": "636-875-3157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "923 MIDPOINT DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633665906",
"telephone_number": "636-875-3157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAEZ",
"first_name": "MAURO",
"middle_name": "ALCALA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-10",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "MO",
"license": "2007000648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O'Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.