| Hospitalist Medicine Physicians Of Missouri - Bridgeton, Inc. | |
|
12303 De Paul Dr Bridgeton MO 63044-2512 | |
| (314) 344-6000 | |
| Not Available |
| Full Name | Hospitalist Medicine Physicians Of Missouri - Bridgeton, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 12303 De Paul Dr, Bridgeton, Missouri |
| Authorized Official Name and Position | Robert Bessler (PRESIDENT) |
| Authorized Official Contact | 6153775658 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospitalist Medicine Physicians Of Missouri - Bridgeton, Inc. 5410 Maryland Way Ste 300 Brentwood TN 37027-5339 Ph: (615) 377-5658 | Hospitalist Medicine Physicians Of Missouri - Bridgeton, Inc. 12303 De Paul Dr Bridgeton MO 63044-2512 Ph: (314) 344-6000 |
| NPI Number | 1275012452 |
|---|---|
| Provider Enumeration Date | 08/09/2018 |
| Last Update Date | 08/09/2018 |
| Medicare PECOS PAC ID | 2567713571 |
|---|---|
| Medicare Enrollment ID | O20181001001537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275012452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ping Chang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124091194 PECOS PAC ID: 1355253006 Enrollment ID: I20031103000203 |
| Provider Name | Imran A Hanafi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588637516 PECOS PAC ID: 7618950155 Enrollment ID: I20040608000193 |
| Provider Name | Christopher Lynn Hill |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366434896 PECOS PAC ID: 8022082759 Enrollment ID: I20040819001250 |
| Provider Name | Mehreen B Khann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942292420 PECOS PAC ID: 2567422793 Enrollment ID: I20041013000101 |
| Provider Name | Sriram Vissa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558334573 PECOS PAC ID: 0143281675 Enrollment ID: I20041019000853 |
| Provider Name | Rajeshwar Peddi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043283989 PECOS PAC ID: 8729042544 Enrollment ID: I20041112000042 |
| Provider Name | Sanjay Mughal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538199781 PECOS PAC ID: 9234187261 Enrollment ID: I20050106000602 |
| Provider Name | Cary L Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184679326 PECOS PAC ID: 3678521341 Enrollment ID: I20050110000470 |
| Provider Name | Philip B Vaidyan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669445508 PECOS PAC ID: 0648204628 Enrollment ID: I20050920000285 |
| Provider Name | Olujoke B Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629028667 PECOS PAC ID: 5092609032 Enrollment ID: I20051003000443 |
| Provider Name | Sasibala S Vinjamoori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801861497 PECOS PAC ID: 9830111707 Enrollment ID: I20051221000011 |
| Provider Name | Vicki J Carll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710902176 PECOS PAC ID: 6002838620 Enrollment ID: I20051227000002 |
| Provider Name | Surajit Majumdar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548216179 PECOS PAC ID: 3870517196 Enrollment ID: I20060125000327 |
| Provider Name | Huilin Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003925041 PECOS PAC ID: 1951308832 Enrollment ID: I20061107000409 |
| Provider Name | Sonianagaraj Melkaveri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184741860 PECOS PAC ID: 3779689658 Enrollment ID: I20070509000707 |
| Provider Name | George Mekhjian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407802812 PECOS PAC ID: 0840293437 Enrollment ID: I20070718000050 |
| Provider Name | Romina Sohail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689873267 PECOS PAC ID: 0749372050 Enrollment ID: I20070816000268 |
| Provider Name | Luann B Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649321860 PECOS PAC ID: 5597852822 Enrollment ID: I20071101000722 |
| Provider Name | Lavada Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164691945 PECOS PAC ID: 8921184813 Enrollment ID: I20080318000257 |
| Provider Name | Asif Shahzad Bhutto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205093473 PECOS PAC ID: 0648342717 Enrollment ID: I20080707000307 |
| Provider Name | Olga Rudomiotov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497965990 PECOS PAC ID: 8628141058 Enrollment ID: I20080718000192 |
| Provider Name | Devinder P Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740482710 PECOS PAC ID: 1557435716 Enrollment ID: I20080806000127 |
| Provider Name | Stephanie N Piotter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649420233 PECOS PAC ID: 6204994379 Enrollment ID: I20081017000331 |
| Provider Name | Jami Davis-jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629243886 PECOS PAC ID: 7810050804 Enrollment ID: I20090119000031 |
| Provider Name | Umesh I Gandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205056660 PECOS PAC ID: 8527111384 Enrollment ID: I20090929000366 |
| Provider Name | Heidi A Israel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912132283 PECOS PAC ID: 4082750385 Enrollment ID: I20090929000599 |
| Provider Name | Muhammad A Aziz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942466859 PECOS PAC ID: 9133261555 Enrollment ID: I20100123000171 |
| Provider Name | Lavondia L Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235460163 PECOS PAC ID: 2567597792 Enrollment ID: I20100312000853 |
| Provider Name | Nizar G Al Nimri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679738678 PECOS PAC ID: 7113053281 Enrollment ID: I20100327000530 |
| Provider Name | Nadeem N Sufi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629041553 PECOS PAC ID: 8123938933 Enrollment ID: I20100626000243 |
| Provider Name | Fatima A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083687669 PECOS PAC ID: 9638201874 Enrollment ID: I20100723000008 |
| Provider Name | Peninnah M Mutungi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720251945 PECOS PAC ID: 4183793433 Enrollment ID: I20100802000034 |
| Provider Name | Usha Muthyala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396935888 PECOS PAC ID: 4981738614 Enrollment ID: I20100817001283 |
| Provider Name | Ilir Polovina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952540999 PECOS PAC ID: 5991820102 Enrollment ID: I20100910001149 |
| Provider Name | Anjali Sanjeev Kamat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578729471 PECOS PAC ID: 6002008232 Enrollment ID: I20101006001114 |
| Provider Name | Parthasarathi R Marapareddigari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487962494 PECOS PAC ID: 2365636628 Enrollment ID: I20101030000238 |
| Provider Name | Bethany Noelle Catlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437459666 PECOS PAC ID: 6002004124 Enrollment ID: I20101216000022 |
| Provider Name | Seow Voon Yew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942518675 PECOS PAC ID: 3173795382 Enrollment ID: I20111012000697 |
| Provider Name | Donte Mcclary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689647497 PECOS PAC ID: 9436063179 Enrollment ID: I20111117000148 |
| Provider Name | Ali Husain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154525707 PECOS PAC ID: 3971674540 Enrollment ID: I20120119000751 |
| Provider Name | Penny D Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881617116 PECOS PAC ID: 7113967977 Enrollment ID: I20120203000478 |
| Provider Name | George N Ntui-ayuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760796775 PECOS PAC ID: 7719134386 Enrollment ID: I20120904000723 |
| Provider Name | Monu Khanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962432815 PECOS PAC ID: 3870595465 Enrollment ID: I20121009000807 |
| Provider Name | Joseph M Boyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578724068 PECOS PAC ID: 6709036411 Enrollment ID: I20130418000225 |
| Provider Name | Naveen Bondalapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104147214 PECOS PAC ID: 3779724406 Enrollment ID: I20130816000361 |
| Provider Name | Elizabeth A Remus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194954099 PECOS PAC ID: 8123252467 Enrollment ID: I20130927000718 |
| Provider Name | Nicka Khalilova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598102204 PECOS PAC ID: 2860626348 Enrollment ID: I20131018001351 |
| Provider Name | Srikanth Nadella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740599109 PECOS PAC ID: 9537396635 Enrollment ID: I20131217001298 |
| Provider Name | Peter Scott Emerson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023045655 PECOS PAC ID: 9739274226 Enrollment ID: I20131217001707 |
| Provider Name | Gary Luther Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528336294 PECOS PAC ID: 6709013683 Enrollment ID: I20131223000190 |
| Provider Name | Mian Rizwan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437380276 PECOS PAC ID: 0042460412 Enrollment ID: I20140228001479 |
| Provider Name | Tamer A Dabous |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356506711 PECOS PAC ID: 0446476709 Enrollment ID: I20140722000905 |
| Provider Name | Zahira Rosario |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124009238 PECOS PAC ID: 4082688916 Enrollment ID: I20140726000057 |
| Provider Name | Rebekah S Allen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710263033 PECOS PAC ID: 9234351800 Enrollment ID: I20141114001467 |
| Provider Name | Mohsin U Qazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437461084 PECOS PAC ID: 6507091469 Enrollment ID: I20141205001733 |
| Provider Name | Asim Ayaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144509563 PECOS PAC ID: 7416279807 Enrollment ID: I20141215001710 |
| Provider Name | Jennifer Rae Huckstep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578969259 PECOS PAC ID: 3476877903 Enrollment ID: I20150109001898 |
| Provider Name | Leann Nitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952701666 PECOS PAC ID: 2769709658 Enrollment ID: I20150403000349 |
| Provider Name | Ahmed S Eljourni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205143468 PECOS PAC ID: 7719206580 Enrollment ID: I20150428001746 |
| Provider Name | Kimberly H Harsy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437555653 PECOS PAC ID: 7113247651 Enrollment ID: I20150522001371 |
| Provider Name | Mary T Mctigue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396122578 PECOS PAC ID: 9234443094 Enrollment ID: I20150806012379 |
| Provider Name | Pankaj Kaul |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376771105 PECOS PAC ID: 8123211919 Enrollment ID: I20160115000724 |
| Provider Name | Asaph Githunguri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619340650 PECOS PAC ID: 4981909785 Enrollment ID: I20160216001124 |
| Provider Name | Noura Zakari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346614161 PECOS PAC ID: 5799084422 Enrollment ID: I20160502002397 |
| Provider Name | Fang Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841630647 PECOS PAC ID: 0749582575 Enrollment ID: I20160721001171 |
| Provider Name | Nitin Sainani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952745093 PECOS PAC ID: 8123327921 Enrollment ID: I20160803001307 |
| Provider Name | Cheng Chu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578824058 PECOS PAC ID: 6800198359 Enrollment ID: I20160815000392 |
| Provider Name | Kimberly Ann Galmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255788923 PECOS PAC ID: 8628363322 Enrollment ID: I20160819000698 |
| Provider Name | Omar Ali Mohammad Mahasneh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124361746 PECOS PAC ID: 3274831417 Enrollment ID: I20160825002776 |
| Provider Name | Tahreem S Aziz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962847129 PECOS PAC ID: 6002058666 Enrollment ID: I20160906000108 |
| Provider Name | Evgeniy Kulik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336503598 PECOS PAC ID: 8426344250 Enrollment ID: I20160906000123 |
| Provider Name | Joseph Arnold Baidoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164798534 PECOS PAC ID: 3072777838 Enrollment ID: I20160927000199 |
| Provider Name | Nadeem Najam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982669495 PECOS PAC ID: 9032178934 Enrollment ID: I20161018002488 |
| Provider Name | Warren O Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548718448 PECOS PAC ID: 2769770163 Enrollment ID: I20161018002774 |
| Provider Name | Geetha Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356898381 PECOS PAC ID: 2860770120 Enrollment ID: I20161021000196 |
| Provider Name | Betty Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649725987 PECOS PAC ID: 8022398221 Enrollment ID: I20161205001928 |
| Provider Name | Guo Phoenix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396901062 PECOS PAC ID: 5597935643 Enrollment ID: I20161221000552 |
| Provider Name | Cyriacus Anaele |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1942456256 PECOS PAC ID: 2769541366 Enrollment ID: I20170118001413 |
| Provider Name | Michelle R Mick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033652862 PECOS PAC ID: 2961784277 Enrollment ID: I20170123000581 |
| Provider Name | Sabina Gallion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316205305 PECOS PAC ID: 2860708971 Enrollment ID: I20170308001854 |
| Provider Name | Wesam A. Bolkhir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407060189 PECOS PAC ID: 0042347486 Enrollment ID: I20170501000260 |
| Provider Name | Joel Kalavelil |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801234810 PECOS PAC ID: 3577796457 Enrollment ID: I20170501000434 |
| Provider Name | Jared M Hu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770023608 PECOS PAC ID: 5597042382 Enrollment ID: I20170504000265 |
| Provider Name | Anton Marek Clemmons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225163454 PECOS PAC ID: 5799868451 Enrollment ID: I20170518000472 |
| Provider Name | Owais Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184911695 PECOS PAC ID: 7810136769 Enrollment ID: I20170601001444 |
| Provider Name | Arfaa Hardi Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295146421 PECOS PAC ID: 6406158864 Enrollment ID: I20170623000488 |
| Provider Name | Schola Nwachukwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548555782 PECOS PAC ID: 0244552537 Enrollment ID: I20170719001789 |
| Provider Name | Annie J Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295022705 PECOS PAC ID: 0547439614 Enrollment ID: I20170719001853 |
| Provider Name | Yang Yu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538573092 PECOS PAC ID: 1557664877 Enrollment ID: I20170719002657 |
| Provider Name | Adrianna Kelmendi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528475621 PECOS PAC ID: 1456641414 Enrollment ID: I20170721001233 |
| Provider Name | Maki Katagiri Cronin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558899377 PECOS PAC ID: 0547530594 Enrollment ID: I20170724002873 |
| Provider Name | Shazia Abbas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205086998 PECOS PAC ID: 3779751086 Enrollment ID: I20170725000464 |
| Provider Name | Francis O Onwochei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225404650 PECOS PAC ID: 7719258037 Enrollment ID: I20170804002305 |
| Provider Name | Anita Haugabrook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699710442 PECOS PAC ID: 6608789292 Enrollment ID: I20170814000895 |
| Provider Name | Sharion R Settle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356870372 PECOS PAC ID: 8820360753 Enrollment ID: I20170828000459 |
| Provider Name | Abdelrazig B Suliman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396163408 PECOS PAC ID: 0042519142 Enrollment ID: I20170829002609 |
| Provider Name | Steven Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013353663 PECOS PAC ID: 8921371139 Enrollment ID: I20170911002281 |
| Provider Name | Sam Valid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912318783 PECOS PAC ID: 1456668185 Enrollment ID: I20171010002643 |
| Provider Name | Amanda M Huxtable |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295253581 PECOS PAC ID: 4587930474 Enrollment ID: I20171020000612 |
| Provider Name | Lauren E Skyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811406242 PECOS PAC ID: 1658647342 Enrollment ID: I20171025000204 |
| Provider Name | Mark Knotts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750809224 PECOS PAC ID: 0446516298 Enrollment ID: I20171109003525 |
| Provider Name | Shashi Dhar Rajuri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144576075 PECOS PAC ID: 4486973682 Enrollment ID: I20171220000152 |
| Provider Name | Amanda Barich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376074054 PECOS PAC ID: 2668732983 Enrollment ID: I20180207000245 |
| Provider Name | Audrey Anne Bolden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316455959 PECOS PAC ID: 1153682448 Enrollment ID: I20180301001157 |
| Provider Name | Venkat D Arukala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205210887 PECOS PAC ID: 4486921889 Enrollment ID: I20180313000909 |
| Provider Name | Anshu Sood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659598225 PECOS PAC ID: 6608934666 Enrollment ID: I20180326000329 |
| Provider Name | David M Hayes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396130852 PECOS PAC ID: 0547562977 Enrollment ID: I20180607001568 |
| Provider Name | Michael F Donovan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669852448 PECOS PAC ID: 8426351974 Enrollment ID: I20180625000789 |
| Provider Name | Mohamed Hassan Halane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639306442 PECOS PAC ID: 3971738725 Enrollment ID: I20180628001906 |
| Provider Name | Abraham D Bezuneh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508238130 PECOS PAC ID: 4385990183 Enrollment ID: I20180710000994 |
| Provider Name | Worku Haile |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679951214 PECOS PAC ID: 9133475650 Enrollment ID: I20180712003013 |
| Provider Name | Grant Kerr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700253002 PECOS PAC ID: 1254613169 Enrollment ID: I20180717000436 |
| Provider Name | Micahla Christina Brown |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184010589 PECOS PAC ID: 5698077964 Enrollment ID: I20180726001603 |
| Provider Name | Anoushiravan Hakim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407237274 PECOS PAC ID: 1557667458 Enrollment ID: I20181016000220 |
| Provider Name | Maanjot K Rathore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659767051 PECOS PAC ID: 8224330626 Enrollment ID: I20181016001651 |
| Provider Name | Amin H Jiminian Wilmot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710268412 PECOS PAC ID: 5799931788 Enrollment ID: I20181016001682 |
| Provider Name | Prachi Mayenkar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013336023 PECOS PAC ID: 9133497902 Enrollment ID: I20181025002281 |
| Provider Name | Burt Humburg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013134469 PECOS PAC ID: 4981652070 Enrollment ID: I20181030002583 |
| Provider Name | Babatunde A Olumide |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689771875 PECOS PAC ID: 6103859004 Enrollment ID: I20181218003206 |
| Provider Name | He Zhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699156414 PECOS PAC ID: 9335441146 Enrollment ID: I20190314000660 |
| Provider Name | Joy Ugonma Ekenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891263190 PECOS PAC ID: 6709128861 Enrollment ID: I20190422001703 |
| Provider Name | Anant Vinjamoori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689088999 PECOS PAC ID: 6406194315 Enrollment ID: I20190523001151 |
| Provider Name | Elena A Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336703883 PECOS PAC ID: 8921333741 Enrollment ID: I20190716000781 |
| Provider Name | Rameez Malik |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376999417 PECOS PAC ID: 1254660905 Enrollment ID: I20190906000225 |
| Provider Name | Omer Afzal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881093052 PECOS PAC ID: 0143590505 Enrollment ID: I20190910002436 |
| Provider Name | Gloria Ann Elio Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114565835 PECOS PAC ID: 5890123541 Enrollment ID: I20200312001004 |
| Provider Name | Ali Ghani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013392018 PECOS PAC ID: 8628382546 Enrollment ID: I20200415002534 |
| Provider Name | Christian G Caceres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255787628 PECOS PAC ID: 6002194701 Enrollment ID: I20200506002538 |
| Provider Name | Melissa Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437633716 PECOS PAC ID: 5799026977 Enrollment ID: I20200526002411 |
| Provider Name | Laith Mansour Numan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730611542 PECOS PAC ID: 8729350046 Enrollment ID: I20200818001977 |
| Provider Name | Mohammed Hamid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063942589 PECOS PAC ID: 4486064490 Enrollment ID: I20201103001272 |
| Provider Name | Fowad Shahzad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568708428 PECOS PAC ID: 1850532532 Enrollment ID: I20201217002009 |
| Provider Name | Kimberly M Boyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033601356 PECOS PAC ID: 3971920455 Enrollment ID: I20210308002500 |
| Provider Name | Numan Choudhry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528591633 PECOS PAC ID: 6507273901 Enrollment ID: I20210331002763 |
| Provider Name | Vineela Bandarupalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700174562 PECOS PAC ID: 7315162823 Enrollment ID: I20210630002844 |
| Provider Name | Okeyo Oghina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184003261 PECOS PAC ID: 9436218138 Enrollment ID: I20210805000433 |
| Provider Name | Wally Folad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326331893 PECOS PAC ID: 8022237841 Enrollment ID: I20210805000662 |
| Provider Name | Hanesh Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720494958 PECOS PAC ID: 4082983317 Enrollment ID: I20210820001459 |
| Provider Name | Soumojit Ghosh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003310822 PECOS PAC ID: 0446505069 Enrollment ID: I20210824003085 |
| Provider Name | Hannah Adler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528563269 PECOS PAC ID: 7517217896 Enrollment ID: I20210831001889 |
| Provider Name | Samreen Masood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497174486 PECOS PAC ID: 7618249350 Enrollment ID: I20210902002971 |
| Provider Name | Hunain Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265927081 PECOS PAC ID: 1557611555 Enrollment ID: I20210907000190 |
| Provider Name | Farrukh Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023514999 PECOS PAC ID: 0941606503 Enrollment ID: I20210907001568 |
| Provider Name | Michael Ambrose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538398680 PECOS PAC ID: 2961489034 Enrollment ID: I20210913001283 |
| Provider Name | Nachiket Nitin Datar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104310671 PECOS PAC ID: 8325444623 Enrollment ID: I20210913001500 |
| Provider Name | Syed Ali Umair Zaidi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700377140 PECOS PAC ID: 6507262805 Enrollment ID: I20210913001552 |
| Provider Name | Jonathan Buck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861847790 PECOS PAC ID: 0446538003 Enrollment ID: I20210914001466 |
| Provider Name | Dorian G Shimotani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407344393 PECOS PAC ID: 5496001042 Enrollment ID: I20210914001756 |
| Provider Name | Nirmal Ilesh Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346746260 PECOS PAC ID: 6305235904 Enrollment ID: I20211122000809 |
| Provider Name | Naveenkumar B Krishna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417180704 PECOS PAC ID: 6709010085 Enrollment ID: I20211206002255 |
| Provider Name | Onyema Nnanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164872768 PECOS PAC ID: 7416224175 Enrollment ID: I20220329001318 |
| Provider Name | Shaheryar Jafri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033595830 PECOS PAC ID: 5597027649 Enrollment ID: I20220509001795 |
| Provider Name | Evan Schultz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194212878 PECOS PAC ID: 1658600986 Enrollment ID: I20220516000180 |
| Provider Name | Jennifer Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386938686 PECOS PAC ID: 3577780485 Enrollment ID: I20220524000482 |
| Provider Name | Pooja Mohan Padigala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346777620 PECOS PAC ID: 4789015215 Enrollment ID: I20220524001198 |
| Provider Name | John Sifuentes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154433621 PECOS PAC ID: 5395711980 Enrollment ID: I20220616001324 |
| Provider Name | Ebikaboere Ejimofor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033538616 PECOS PAC ID: 0244504553 Enrollment ID: I20220616001708 |
| Provider Name | Joel Thekekara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336646199 PECOS PAC ID: 7810396116 Enrollment ID: I20220708000650 |
| Provider Name | Taimoor Haider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659924017 PECOS PAC ID: 7214361492 Enrollment ID: I20220714003443 |
| Provider Name | Muhammad Umar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942760731 PECOS PAC ID: 2062746712 Enrollment ID: I20220720001900 |
| Provider Name | Seon Kyo Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407412760 PECOS PAC ID: 6901132562 Enrollment ID: I20220816002925 |
| Provider Name | Ricky Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649633173 PECOS PAC ID: 7012254527 Enrollment ID: I20220823002246 |
| Provider Name | Rana Ahmed Tauseen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215589866 PECOS PAC ID: 8628453511 Enrollment ID: I20220913001942 |
| Provider Name | Basanta Subedi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124683495 PECOS PAC ID: 4486039377 Enrollment ID: I20220913002271 |
| Provider Name | Muhammad Atique Alam Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609338656 PECOS PAC ID: 9335477579 Enrollment ID: I20220922000563 |
| Provider Name | Abdul Rauf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619533890 PECOS PAC ID: 9133505423 Enrollment ID: I20221011001097 |
Family Medicine At Depaul Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12255 De Paul Dr, Suite 200, Bridgeton, MO 63044 Phone: 314-344-7600 Fax: 314-344-7850 | |
Specialist In Aging Successfully Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3466 Bridgeland Dr Ste 105, Bridgeton, MO 63044 Phone: 314-209-5100 | |
Bimla Dhan Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3394 Mckelvey Rd Ste 115, Bridgeton, MO 63044 Phone: 314-643-7692 | |
Metro Medical Institute Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12174 Natural Bridge Rd, Bridgeton, MO 63044 Phone: 314-563-3431 | |
Midwest Rehab Hospitalist, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3394 Mckelvey Rd Ste 115, Bridgeton, MO 63044 Phone: 636-675-1194 | |
Bridgeton Pain Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11520 Saint Charles Rock Rd Ste 201, Bridgeton, MO 63044 Phone: 314-526-6093 | |
Family Care Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12255 De Paul Dr, Suite 600, Bridgeton, MO 63044 Phone: 314-291-1074 Fax: 314-291-0802 |