Active NPI
Elena Minakova, MD
- Neonatal-Perinatal Medicine Physician
- Saint Louis, MO
National Provider Identifier
1902049604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 2017009636
- Practice address
- 1 Childrens PL
Div Ped Newborn Medicine
Saint Louis, MO 63110-1002 - Phone
- (314) 454-2683
- Fax
- (314) 454-4633
- NPI assigned
- Apr 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2017009636 | MO | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 2017009636 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL
Div Ped Newborn Medicine
Saint Louis, MO 63110-1002
Mailing address
1 Childrens PL
MSC 8515-87-1200
Saint Louis, MO 63110-1002
Phone (314) 454-2683
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200043862 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
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 |
|---|---|---|---|
| Northbay Neonatology Associates, Inc | Neonatal-Perinatal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Neonatal-Perinatal Medicine Physician
- Vallejo, CA
- NPI 1265513360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637020800000",
"number": "1902049604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "MSC 8515-87-1200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-2683",
"fax_number": "314-454-4633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "DIV PED NEWBORN MEDICINE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-2683",
"fax_number": "314-454-4633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINAKOVA",
"first_name": "ELENA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-09",
"last_updated": "2021-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2017009636",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "MO",
"license": "2017009636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200043862",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "1 Childrens Pl",
"address_2": "Div Ped Newborn Medicine",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101002",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.