Roger V. Vardeleon, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R4094 Issued in MO

Practice address

327 Conway Lake Dr
Saint Louis, MO 63141-8114

Phone

(314) 576-4042

Fax

(314) 576-4042

NPI assigned

Aug 30, 2006

Last updated

Jan 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1972613826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 CONWAY LAKE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418114",
            "telephone_number": "314-576-4042",
            "fax_number": "314-576-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 CONWAY LAKE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418114",
            "telephone_number": "314-576-4042",
            "fax_number": "314-576-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDELEON",
        "first_name": "ROGER",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "R4094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200138915",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana del Carmen Vaquer-Alicea, MD
• Swarup Sri Varaday, MD
• Arun Seevaram Varadhachary, MD
• Alexander Varasteh, MD
• William R Vardaro, CRNA
• Britney Vardeman
• Gil M Vardi, M.D.
• Juliana Varela, LCSW
• Raquel Varela, DPT
• Attila L Varga, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.