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SPECIALIST IN GASTROENTEROLOGY
NPI 1669523270
Internal Medicine - Gastroenterology in Creve Coeur, MO

Active since January 12, 2007CLIA 26D0711664 · Waiver
11525 OLDE CABIN RD, CREVE COEUR, MO 63141(314) 997-0554(314) 997-5086 Get Directions Write a Review

NPPES record last updated: April 25, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Specialist In Gastroenterology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPECIALIST IN GASTROENTEROLOGY (NPI 1669523270) is a healthcare organization registered as a gastroenterology in Creve Coeur, Missouri and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through September 8, 2026 and lists Paula D Willis, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1669523270
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameSPECIALIST IN GASTROENTEROLOGY
Location Address11525 OLDE CABIN RDCreve Coeur, MO 63141-7146
Mailing Address11525 Olde Cabin RdCreve Coeur, MO 63141-7146 · (314) 997-0554 · Fax (314) 997-5086
Phone(314) 997-0554
Fax(314) 997-5086
Organization SubpartNo
Authorized OfficialPaula D WillisOffice Administrator · (314) 997-0554
Enumeration DateJanuary 12, 2007
Last NPPES UpdateApril 25, 2008
✔ NPI 1669523270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in MO · R4F99
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
11525 OLDE CABIN RD, Creve Coeur, MO 63141
Open in Google Maps ↗

Other Identifiers 4

Medicaid501218002MO
Other000012657MO · Medicare
OtherCG0207Railroad Medicare
Other31998Ghp

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0711664

Specialists In Gastroenterology · Saint Louis, MO
Active · expires Sep 8, 2026
CLIA Number26D0711664
Laboratory TypePhysician Office
Certificate Effective DateSeptember 9, 2024
Certificate Expiration DateSeptember 8, 2026
Laboratory DirectorLeonard B. Weinstock
Laboratory Phone(314) 997-0554
Laboratory LocationSpecialists In Gastroenterology11525 Olde Cabin Road, Saint Louis, MO 63141
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUMOJIT GHOSH MD
Internal Medicine (Gastroenterology)
11525 OLDE CABIN RD
CREVE COEUR, MO 63141
St. Louis County (314) 997-0554
MS. AMIE C CHANG P.A.
Physician Assistant
11525 OLDE CABIN RD
CREVE COEUR, MO 63141
St. Louis County (314) 997-0554
JANET TODORCZUK MD
Internal Medicine (Gastroenterology)
11525 OLDE CABIN RD
CREVE COEUR, MO 63141
St. Louis County (314) 997-0554
LEONARD B WEINSTOCK MD
Internal Medicine (Gastroenterology)
11525 OLDE CABIN RD
CREVE COEUR, MO 63141
St. Louis County (314) 997-0554
ROMAN HAILU FNP
Nurse Practitioner
11525 OLDE CABIN RD
SAINT LOUIS, MO 63141
St. Louis County (314) 997-0554
AMAN K SINGH MD
Internal Medicine (Gastroenterology)
11525 OLDE CABIN RD
SAINT LOUIS, MO 63141
St. Louis County (314) 997-0554
BENJAMIN ZIMMERMAN ROOT M.D.
Internal Medicine (Gastroenterology)
11525 OLDE CABIN RD
SAINT LOUIS, MO 63141
St. Louis County (314) 279-9049
MR. NIKHIL BANERJEE M.D.
Internal Medicine (Gastroenterology)
11525 OLDE CABIN RD
SAINT LOUIS, MO 63141
St. Louis County (314) 997-0554

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 Specialist In Gastroenterology's NPI number?

The NPI number for Specialist In Gastroenterology is 1669523270. It was assigned to this organization in the NPPES registry on January 12, 2007.

Where is Specialist In Gastroenterology located?

Specialist In Gastroenterology is located at 11525 Olde Cabin Rd, Creve Coeur, MO 63141. The listed phone number is (314) 997-0554.

What is Specialist In Gastroenterology's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Specialist In Gastroenterology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0711664) is associated with this NPI, valid through September 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Specialist In Gastroenterology accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 other insurers list Specialist In Gastroenterology as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Specialist In Gastroenterology was last updated on April 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.