SEAN LEWIS EDELSTEIN (NPI# 1679520605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679520605 |
| Entity Type | Individual |
| Full Name | SEAN LEWIS EDELSTEIN |
| Credential | MD |
| Practice Address |
1225 S Grand Blvd Saint Louis MO 63104-1016 |
| Mailing Address |
1008 S Spring Ave Saint Louis MO 63110-2520 |
| Practice Telephone | 3149775200 |
| Practice Fax Number | 3149773495 |
| Mailing Telephone | 3149774010 |
| Mailing Fax Number | 3149773495 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 2005019369 | MO | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 2005019369 | MO | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 2005019369 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 200839009 | 05 | |
| MO | 1679520605 | 05 |
| Street Address |
1225 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265496871 | Thomas I Porter | Optometrist | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2006-04-12 |
| 1629695838 | Ssm-sluh, Inc. | Pharmacy | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2020-07-03 |
| 1740838333 | Eduardo Buchele Rodrigues | Ophthalmology | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2019-08-28 |
| 1528596566 | Katie M Loock | Optometrist | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2017-06-02 |
| 1356725832 | Muhammad Zaheer | Internal Medicine | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2015-07-15 |
| 1225428980 | Niloofar Piri | Ophthalmology | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2015-02-02 |
| 1689099830 | Swetaben Patel | Nurse Practitioner | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2014-02-25 |
| 1679998272 | Angela Prost Keller | Nurse Practitioner | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2014-02-19 |
| 1255763561 | Lokesh Rukmangadachar | Psychiatry & Neurology | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2013-08-08 |
| 1598106874 | Momina Soudagar Turkey | Psychiatry & Neurology | 1225 S Grand Blvd, Saint Louis, MO 63104-1016 | 2013-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790265759 | Washington University | Ophthalmology | 4901 Forest Park Ave # 8221, Saint Louis, MO 63108-1495 | 2018-08-20 |
| 1184038986 | Grace L Paley | Ophthalmology | 621 S New Ballas Rd Ste 5006b, Saint Louis, MO 63141-8270 | 2014-06-19 |
| 1992140958 | Andrew Robert Lee | Ophthalmology | 660 S Euclid Ave # 8096, Saint Louis, MO 63110-1010 | 2013-05-03 |
| 1083941488 | William Steven Joffe | Ophthalmology | 4912 Mcpherson Ave, Saint Louis, MO 63108-1608 | 2009-11-06 |
| 1033349741 | Nancy Buchser | Ophthalmology | 4921 Parkview Pl Ste 14f, Saint Louis, MO 63110-1032 | 2009-07-16 |
| 1730316449 | Augustine Richard Hong | Ophthalmology | 5201 Mid America Plz Ste 2500, Ste 2500, Saint Louis, MO 63129-0002 | 2009-06-20 |
| 1548470032 | Fe Poblete Fuentes | Ophthalmology | 84 Grasso Plz, Saint Louis, MO 63123-3108 | 2007-05-23 |
| 1255543047 | Malaz Safi, M.d., P.C. | Ophthalmology | 8790 Watson Rd Ste 203, Saint Louis, MO 63119-5140 | 2007-05-04 |
| 1063535623 | Therese M Alban | Ophthalmology | 12395 Olive Blvd, Suite 301, Saint Louis, MO 63141-5462 | 2007-04-09 |
| 1902924368 | Eye Specialists of West County, P.C. | Ophthalmology | 777 S New Ballas Rd Ste 218e, Saint Louis, MO 63141-8718 | 2007-03-26 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.