GATEWAY GERIATRIC SERVICES LLC
NPI 1114219417
Internal Medicine - Geriatric Medicine in Saint Louis, MO
About Gateway Geriatric Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GATEWAY GERIATRIC SERVICES LLC (NPI 1114219417) is a healthcare organization registered as a geriatric medicine in Saint Louis, Missouri and active in the NPI registry since May 2011. The organization lists Shailaja Pulisetty, Physician/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gateway Geriatric Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Gateway Geriatric Services LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gateway Geriatric Services LLC's NPI number?
The NPI number for Gateway Geriatric Services LLC is 1114219417. It was assigned to this organization in the NPPES registry on May 5, 2011.
Where is Gateway Geriatric Services LLC located?
Gateway Geriatric Services LLC is located at 12026 Conway Rd, Saint Louis, MO 63131. The listed phone number is (314) 225-6015.
What is Gateway Geriatric Services LLC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.
Is Gateway Geriatric Services LLC enrolled in Medicare?
Yes. Gateway Geriatric Services LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Gateway Geriatric Services LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Gateway Geriatric Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Gateway Geriatric Services LLC was last updated on July 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gateway Geriatric Services Llc · NPI 1114219417
Geriatric Medicine organization in Saint Louis, Missouri. Organization record, active in the CMS NPPES registry since May 5, 2011.
## Identity
- **NPI:** 1114219417 (Entity type: Organization)
- **Enumerated:** May 5, 2011
- **Primary specialty:** Internal Medicine - Geriatric Medicine · taxonomy 207RG0300X
- **Organization subpart:** No
- **Authorized official:** Shailaja Pulisetty, PHYSICIAN/PRESIDENT
## Practice location
- **Address:** 12026 CONWAY RD, Saint Louis, MO 63131-2417
- **Phone:** (314) 225-6015
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 13, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1114219417) · Data from the CMS NPPES public registry.