Elie C Azrak, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

106181 Issued in MO

Practice address

12266 De Paul Dr Ste 205
Bridgeton, MO 63044-2514

Phone

(314) 218-2300

NPI assigned

Aug 25, 2005

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

Other identifiers 13

Electronic endpoints 2

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

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eazrak361@direct-ehr-ssmhc.com

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.

• SSM Health Care St Louis

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Critical Care Services, P.C.

  • Multi-Specialty Clinic/Center
  • St. Louis, MO
  • NPI 1942256250
  NPD (past)
• SSM Depaul Medical Group, Inc.

  • Family Medicine Physician
  • Florissant, MO
  • NPI 1952312951
  NPD (past)
• SSM Health Care St. Louis

  • Emergency Medicine Physician
  • Wentzville, MO
  • NPI 1588618755

  Cardiovascular Disease

  NPD (past)
• St Louis Cardiology Consultants LTD

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1386809663
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1962495952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631956119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DE PAUL DR STE 205",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-218-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11133 Dunn Rd",
            "address_2": "Suite 2346",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366119",
            "country_code": "US",
            "telephone_number": "314-653-5125",
            "fax_number": "314-653-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZRAK",
        "first_name": "ELIE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036110194",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "106181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOBC/BS, BLUE CHOICE",
            "identifier": "183083",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "431098908",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FMH",
            "identifier": "072208",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "435756",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9779268001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MORRMCR",
            "identifier": "P00289356",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MORRMCR",
            "identifier": "P00279137",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "185761V3831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000013096",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204870026",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "22724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "G57442",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILRRMCR",
            "identifier": "P00149798",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eazrak361@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "eazrak361@direct-ehr-ssmhc.com",
            "address_1": "12266 De Paul Dr Ste 205",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "12266 De Paul Dr Ste 205",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Audiology Consultants, LLC
• Derrick Kenneth Austin
• Lindsay Marie Austin, B.S.
• Awakenings Counseling Services, LLC
• Getinet Degu Ayalew, M.D.
• Elisabeth J. Babb, M.D.
• Back Pain Institute of St. Louis, LLC
• Amanda Christine Baebler, PHARMD
• Matthew Robert Baechle
• Karen A Bahow, PT, DPT, NCS

• Cardiovascular Disease Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.