Individual provider Active NPI

Felipe Orellana, MD

  • Internal Medicine Physician
  • St Peters, MO
National Provider Identifier
1922071877
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2001016016 Issued in MO
Practice address
10 Hospital Dr
St Peters, MO 63376-1659
Phone
(314) 317-0600
Fax
(314) 317-0606
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2001016016 MO Primary
Hospitalist Physician 208M00000X 2001016016 MO

Addresses

Primary practice location

10 Hospital Dr
St Peters, MO 63376-1659

Mailing address

12101 Woodcrest Executive Dr
Suite 210
Saint Louis, MO 63141-5047
Phone (314) 317-0600

Other identifiers 2

IdentifierTypeStateIssuer
1922071877MedicaidIL
208433409MedicaidMO

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100811000693 MO Practitioner - Internal Medicine 6608900725 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001016016MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

12303 De Paul Dr
Fl 2
Bridgeton, MO 63044
Phone (314) 344-6285

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

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.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1922071877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415047",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "633761659",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORELLANA",
        "first_name": "FELIPE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2001016016",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2001016016",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922071877",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208433409",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Peters, MO

Sources for this page

Verify at the official NPI Registry.