DR. JOSEPH PRUSACZYK (NPI# 1730295759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730295759 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH PRUSACZYK |
| Credential | MD |
| Practice Address |
13035 Olive Blvd Saint Louis MO 63141-6173 |
| Mailing Address |
1623 Timberlake Manor Pkwy Chesterfield MO 63017-5593 |
| Practice Telephone | 3144343114 |
| Practice Fax Number | 3144343117 |
| Mailing Telephone | 3144343114 |
| Mailing Fax Number | 3144343117 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
31728 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
13035 OLIVE BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-6173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467631259 | Medical Acute Care Center PC | Clinic/Center | 13035 Olive Blvd, Suite 113-115, Saint Louis, MO 63141-6173 | 2007-10-29 |
| 1437373834 | Haikun Li | Family Medicine | 13035 Olive Blvd, Saint Louis, MO 63141-6173 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114048154 | Affton Medical Clinic | Pediatrics | 59 Grasso Plz, Saint Louis, MO 63123-3107 | 2007-04-03 |
| 1932328796 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1760556708 | Ariane E May | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-11-20 |
| 1518030097 | Jill M. Baer | Pediatrics | 3009 N Ballas Rd, Suite 257-c, Saint Louis, MO 63131-2322 | 2006-11-15 |
| 1801999768 | Joyce D Johnson | Pediatrics | 6744 Clayton Rd, Saint Louis, MO 63117-1637 | 2006-09-06 |
| 1649292780 | Sarah Ann Tycast | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1528081544 | Lynn K White | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1023036746 | Maryjo Hernandez-zipfel | Pediatrics | 4055 Lindell Blvd, Saint Louis, MO 63108-3201 | 2006-07-18 |
| 1750310439 | Amal F Antoun | Pediatrics | 1717 Biddle St, Saint Louis, MO 63106-3454 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366670796 | Fernando Fernandez, M. D. PC | Pediatrics | 2750 Clay Edwards Dr Ste 320, North Kansas City, MO 64116-3259 | 2009-06-24 |
| 1073733069 | Kelly Jo Meier | Pediatrics | 2719 E 32nd St, Joplin, MO 64804-3131 | 2007-05-01 |
| 1851417794 | Shari L Smith | Pediatrics | 200 Castle Drive, Joplin, MO 64804-9115 | 2007-03-22 |
| 1811076763 | Nedra Diann Twillie | Pediatrics | 415 Burkarth Rd Ste D, Warrensburg, MO 64093-3101 | 2006-11-03 |
| 1740209162 | Nancy Elizabeth Holmes | Pediatrics | 8888 Ladue Road, Suite 130, St. Louis, MO 63124 | 2006-07-18 |
| 1194770883 | Ann A Gassman | Pediatrics | 503 N Scott Ave, Belton, MO 64012-1730 | 2006-05-23 |
| 1841299161 | Bryson Roy Mchardy Jr. | Pediatrics | 100 Medical Dr, Hannibal, MO 63401-6877 | 2005-07-19 |
| 1245239797 | Jeffrey Paul Yannette | Pediatrics | 821 Sw Lemans Lane, Lees Summit, MO 64082 | 2005-07-18 |
| 1679570618 | Carolyn Ann Ellsworth | Pediatrics | 312 N Kentucky St, West Plains, MO 65775-2073 | 2005-07-06 |
| 1528064102 | Joseph William Stafford Jr. | Pediatrics | 312 N Kentucky Ave, West Plains, MO 65775-2073 | 2005-06-28 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.