| Dr Tatyana R Demidovich, MD | |
|
3635 Vista Ave Fdt3, St Louis University, St Louis, MO 63110 | |
| (314) 577-8750 | |
| Not Available |
| Full Name | Dr Tatyana R Demidovich |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Experience | 26 Years |
| Location | 3635 Vista Ave Fdt3, St Louis, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376539668 | NPI | - | NPPES |
| 200253830 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 01059495A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ssm Health Care Group | 0143608372 | 802 |
| Entity Name | Ssm Health Care Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306589544 PECOS PAC ID: 0143608372 Enrollment ID: O20220531002655 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tatyana R Demidovich, MD 3635 Vista Fdt3, St Louis University, St Louis, MO 63110 Ph: () - | Dr Tatyana R Demidovich, MD 3635 Vista Ave Fdt3, St Louis University, St Louis, MO 63110 Ph: (314) 577-8750 |
Mary Hanna, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 660 South Euclid Avenue, St Louis, MO 63110 Phone: 613-795-4184 | |
Dr. Grant Nicholas Bleeker, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 3015 N Ballas Rd, St Louis, MO 63131 Phone: 314-996-5000 | |
Hui Yuan, MD Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 3635 Vista, St Louis, MO 63110 Phone: 314-577-8750 Fax: 314-268-5102 | |
Jeffrey Owen Bray, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6420 Clayton Road, St Louis, MO 63117 Phone: 314-768-8442 Fax: 314-768-8442 | |
Kumiko Shimoda, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6420 Clayton Road, St Louis, MO 63117 Phone: 314-768-8442 Fax: 314-768-8442 | |
Kevin M Oconnor, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 6420 Clayton Road, St Louis, MO 63117 Phone: 314-768-8442 Fax: 314-768-8442 |