Active NPI
Michael Esare-Beckson
- Physical Therapist
- Saint Louis, MO
National Provider Identifier
1972100535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 20200333857
- Practice address
- 11278 Schuetz Rd
Saint Louis, MO 63146-4957 - Phone
- (314) 991-4066
- NPI assigned
- Oct 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 20200333857 | MO | Primary |
Addresses
Primary practice location
11278 Schuetz Rd
Saint Louis, MO 63146-4957
Mailing address
4433 Pershing Ave Apt 302
Saint Louis, MO 63108-2512
Phone (269) 697-3891
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20200333857 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1972100535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4433 PERSHING AVE APT 302",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082512",
"telephone_number": "269-697-3891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11278 SCHUETZ RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631464957",
"telephone_number": "314-991-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESARE-BECKSON",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-07",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "20200333857",
"primary": true
}
],
"identifiers": [],
"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 Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.