Humberto M Fagundes, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

100121 Issued in MO

Practice address

3015 N New Ballas Rd
St Louis, MO 63131

Phone

(314) 996-5180

Fax

(314) 821-2180

NPI assigned

Aug 29, 2006

Last updated

Mar 7, 2023By the provider in NPPES

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 identifiers 5

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Radiological Associates PC

  • Diagnostic Radiology Physician
  • Saint Louis, MO
  • NPI 1821013418
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1033227806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W PORT PLZ",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463109",
            "telephone_number": "314-548-4772",
            "fax_number": "314-548-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N NEW BALLAS RD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-996-5180",
            "fax_number": "314-821-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGUNDES",
        "first_name": "HUMBERTO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "100121",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "100121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CPIN",
            "identifier": "33012444",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "100121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BNDD",
            "identifier": "32286",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "920004686",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAID",
            "identifier": "207947516",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Fagan, L.P.C., R.N.
• Timothy D Fagen, D.O.
• Johnathan Schnee Fagg, MD
• Louis Faggetti
• Carye Fagin
• Christina Michelle Fahey, MD
• Peter A Fahnestock, MD
• Erica J Fahrner
• Anna J Fahs, OT
• Dorothy Lane Brooke Fahy, PSYD

• Radiation Oncology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Radiation Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.