Individual provider Active NPI

Preeti Dalawari, M.D.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1962598839
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2005005290 Issued in MO
Practice address
3635 Vista Ave
West Pavilion, Room 315
Saint Louis, MO 63110-2539
Phone
(314) 577-8776
Fax
(314) 268-5697
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2005005290 MO Primary

Addresses

Primary practice location

3635 Vista Ave
West Pavilion, Room 315
Saint Louis, MO 63110-2539

Mailing address

3691 Rutger St
Provider Enrollment
Saint Louis, MO 63110-2515
Phone (314) 977-6828

Other identifiers 2

IdentifierTypeStateIssuer
P00273326OtherMORR MEDICARE
207242801MedicaidMO

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

OrganizationSpecialtyStatusNew patients
Doctors for Emergency Service Emergency 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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1962598839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3691 RUTGER ST",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102515",
            "telephone_number": "314-977-6828",
            "fax_number": "314-977-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "address_2": "WEST PAVILION, ROOM 315",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-577-8776",
            "fax_number": "314-268-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAWARI",
        "first_name": "PREETI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2005005290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00273326",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207242801",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "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 Jul 3, 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.