MEDICARE: PRERAK BHARGAV TRIVEDI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	2025039440	MO
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1619611878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRERAK BHARGAV TRIVEDI MD

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE CAMPUS BOX 8072
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BARNES JEWISH HOSPITAL PLZ
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1003
Country	:	US
Telephone Number	:	314-747-4156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2022
Last Update Date	:	03/10/2026

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