| Elizabeth Michelle Grogan, | |
|
1465 S Grand Blvd, Saint Louis, MO 63104-1003 | |
| (314) 617-2000 | |
| Not Available |
| Full Name | Elizabeth Michelle Grogan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Pediatric Critical Care Medicine |
| Location | 1465 S Grand Blvd, Saint Louis, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124589874 | NPI | - | NPPES |
| 0477270 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 35.144435 (Ohio) | Secondary |
| 2080P0203X | Pediatrics - Pediatric Critical Care Medicine | 2026024723 (Missouri) | Primary |
| Entity Name | Pediatric Academic Association, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Michelle Grogan, 700 Childrens Dr, Columbus, OH 43205-2664 Ph: (614) 722-6200 | Elizabeth Michelle Grogan, 1465 S Grand Blvd, Saint Louis, MO 63104-1003 Ph: (314) 617-2000 |
Kavipriya Komeswaran, Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1465 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-617-2000 | |
Dr. Rachel Elizabeth Granberg, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl Msc 8116-0043-09, Saint Louis, MO 63110 Phone: 314-454-6018 Fax: 844-621-4392 | |
Timothy J Kutz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1465 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-268-6406 Fax: 314-268-2712 | |
Dr. William L Rives, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl, Div Ped Hospitalist Med, Saint Louis, MO 63110 Phone: 314-454-2076 Fax: 314-747-8953 | |
Dr. Linda A Tackes, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5114 Mid America Plz, Ste 2c, Saint Louis, MO 63129 Phone: 314-859-4000 Fax: 314-273-4110 | |
Dr. Peter M Kilbridge, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Pl, Suite C, Saint Louis, MO 63110 Phone: 314-454-2479 Fax: 314-454-2524 | |
Sarah B. Aschkenasi, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Saint Louis, MO 63110 Phone: 314-286-1264 Fax: 314-454-8869 |