PETER FONSECA MD, PC (NPI# 1801008396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801008396 |
| Entity Type | Organization |
| Organization Name | PETER FONSECA MD, PC |
| Practice Address |
10004 Kennerly Suite 345a St. Louis MO 63128 |
| Practice Telephone | 3145435252 |
| Practice Fax Number | 3145435211 |
| Mailing Telephone | 3145435252 |
| Mailing Fax Number | 3145435211 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-01-04 |
| Authorized Official Name | DR. PETER FONSECA (PRESIDENT) |
| Authorized Official Telephone | 3145435252 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 116658 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
10004 KENNERLY SUITE 345A |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699074336 | Joseph John Platz | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1035 Belleville Aveune, Suite 500, St. Louis, MO 63117 | 2011-03-21 |
| 1942226162 | Charles Buford Huddleston | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1465 South Grand Blvd., Suite 5730 Cardinal Glennon Hosp., St. Louis, MO 63104-1095 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891034484 | John Phillip Connors | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1733 Kenmont Rd, Saint Louis, MO 63124-1021 | 2013-02-03 |
| 1114243995 | Graham Robertson Young Pollock | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4320 Wornall Rd Ste 50-ii, Kansas City, MO 64111-5941 | 2010-04-19 |
| 1639305055 | George C Kaiser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 Joy Ave, Webster Groves, MO 63119-2502 | 2009-06-01 |
| 1043460710 | Justin Van Meeteren | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2330 E Meyer Blvd Ste 505, Kansas City, MO 64132-1152 | 2008-09-30 |
| 1508024753 | Tracy Elmer Strevey Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1509 Woodgate Dr, Frontenac, MO 63131-4724 | 2008-05-23 |
| 1275712010 | Donovan Mitchell Stinnett | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1701 W 26th St, Suite B, Joplin, MO 64804-1513 | 2007-10-29 |
| 1720277197 | Heart and Vascular Care | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 412 Highway 71, Suite J, Pineville, MO 64856-9310 | 2007-10-22 |
| 1669531182 | James N. Pinckley | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1900 S. National, Suite 3400, Springfield, MO 65804 | 2006-12-08 |
| 1578634226 | Nabil A Munfakh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11155 Dunn Rd Ste 209e, Ste 209e, Saint Louis, MO 63136-6149 | 2006-11-13 |
| 1649355355 | Michael C Murphy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3009 N Ballas Rd Ste 150d, Saint Louis, MO 63131-2322 | 2006-10-25 |
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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.