Sriram Maitra, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-103787 Issued in IL

Practice address

1 Jefferson Barracks Dr
Building 53
Saint Louis, MO 63125-4181

Phone

(314) 894-6408

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sridam Maitra Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inpatient Consultants of Missouri Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1194779579
  NPD (past)
• Care First Medical Center

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1598777435
  NPD (past)
• Lewis County Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Centralia, WA
  • NPI 1811669658
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1013982297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 POLO DOWNS DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "address_2": "BUILDING 53",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-894-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITRA",
        "first_name": "SRIRAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2011024860",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-103787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRIDAM",
            "last_name": "MAITRA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Jill Mainini, LCSW
• Mainline Resources LLC
• Nicholas A. Maio, MSPSY, BCBA , LBA
• Amanda Maisel, MA, LPC
• Baijayanta Maiti, MD
• Nicole Nokubonga Majachani, M.D.
• Majane Home LLC
• Pedram Majbuleh
• Erbab Majeed, D.D.S.
• Mehr Amer Majeed, M.D.

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.