Organization Active NPI

Sangeeta Pande MD LLC

  • Nephrology Physician
  • Bridgeton, MO
National Provider Identifier
1013249606
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2000155017 Issued in MO
Legal business name
SANGEETA PANDE MD LLC
Practice address
12255 De Paul Dr Ste 845
Bridgeton, MO 63044
Phone
(314) 736-4800
Fax
(314) 736-4801
NPI assigned
Feb 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sangeeta Pande, MDNPI 1154375970
Title
MD
Phone
(314) 736-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 2000155017 MO Primary

Addresses

Primary practice location

12255 De Paul Dr Ste 845
Bridgeton, MO 63044

Mailing address

PO Box 1449
Maryland Heights, MO 63043-0449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100423000664 MO Part B Supplier - Clinic/Group Practice 7214064161 Receives reassigned benefits from 5 practitioners
Practice locations: Ofallon, MO; Saint Ann, MO; Saint Louis, MO; Florissant, MO; Saint Peters, MO; Troy, MO; Wentzville, MO; Jennings, MO…
O20120914000586 IL Part B Supplier - Clinic/Group Practice 7214064161 Receives reassigned benefits from 1 practitioner
Practice locations: Alton, IL; Granite City, IL

National Provider Directory

National Provider Directory

Locations

2044 Madison Ave
Ste G15
Granite City, IL 62040
Phone (618) 452-8420

12255 De Paul Dr
Bridgeton, MO 63044
Phone (314) 291-5307

577 Howdershell Rd
Florissant, MO 63031
Phone (314) 831-2178

2125 Bluestone Dr
Saint Charles, MO 63303
Phone (636) 272-5856

12855 N 40 Dr
Ste LL4
Saint Louis, MO 63141
Phone (314) 542-0049

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

6512 Manchester Ave
Saint Louis, MO 63139
Phone (314) 646-7092

3691 Rutger St
#222
Saint Louis, MO 63110
Phone (314) 268-5300

2840 Target Dr
Saint Louis, MO 63136
Phone (314) 355-1322

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIIECD

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528070400000",
    "number": "1013249606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630430449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR STE 845",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-736-4800",
            "fax_number": "314-736-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANGEETA PANDE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-05",
        "last_updated": "2018-06-04",
        "status": "A",
        "authorized_official_last_name": "PANDE",
        "authorized_official_first_name": "SANGEETA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "314-736-4800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2000155017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.