Shailaja Pulisetty, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2005019644 Issued in MO

Practice address

12026 Conway Rd
Saint Louis, MO 63131-2417

Phone

(636) 566-8155

Fax

(636) 566-8732

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shailaja Punjala Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Internal MedicineAlso: Geriatric Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Croix Hospice Hospice, Saint Peters, MO, CCN 261633
• Brooking Park Nursing home, Chesterfield, MO, CCN 265791

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Gateway Geriatric Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1114219417
  Medicare reassignment Authorized official
• National Healthcare of Newport Inc

  • Emergency Medicine Physician
  • Newport, AR
  • NPI 1073720330
  NPD (past)
• National Healthcare of Newport Inc

  • Anesthesiology Physician
  • Newport, AR
  • NPI 1255548517
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nurses & Company Health Care Services Inc

  • Community Based Hospice Care Agency
  • Saint Peters, MO
  • NPI 1871672493
  Care Compare affiliation
• St. Andrews Resources for Seniors

  • Skilled Nursing Facility
  • Chesterfield, MO
  • NPI 1306831011

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1902014467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12026 CONWAY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312417",
            "telephone_number": "636-566-8155",
            "fax_number": "636-566-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12026 CONWAY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312417",
            "telephone_number": "636-566-8155",
            "fax_number": "636-566-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULISETTY",
        "first_name": "SHAILAJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2005019644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAILAJA",
            "last_name": "PUNJALA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel D Pugh, MD
• Jennifer A Pugh, M.D.
• Karen Hill Pugh, M.D.
• Kristine D Pugh, M.S., CCC-A
• Emily Rose Puleo, PHARMD
• Maria Pulizzo, MA, LPC
• Priyanka Pullarkat, MD
• Alfreda Delores Pulley, PHARMACIST
• Arden O Pulley, D.M.D.
• Debra D Pulley, MD

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, 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 May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.