Martin D Jendrisak, MD

Primary specialty

Transplant Surgery PhysicianTaxonomy code 204F00000X

License

R2A43 Issued in MO

Practice address

4921 Parkview PL
Suite 8C
Saint Louis, MO 63110-1032

Phone

(314) 362-2840

Fax

(314) 361-4197

NPI assigned

Jul 14, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1942226253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 FORSYTH",
            "address_2": "C B 8221",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052161",
            "telephone_number": "314-362-2840",
            "fax_number": "314-361-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "SUITE 8C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-2840",
            "fax_number": "314-361-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENDRISAK",
        "first_name": "MARTIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "MO",
            "license": "R2A43",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "R2A43",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Jelinek
• Michael Jelinek, PA-C
• Christina Lee Jemerson, AGNP
• Emily Jen, M.D., PH.D.
• Jenclark, LLC
• Jenec Global Logistic & Insurance LLC
• Keri Noelle Jenkerson, BCBA
• Carolyn Jenkins
• Damithri N Jenkins
• Elizabeth Campbell Jenkins, MSW

• Transplant Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Transplant Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.