Individual provider Active NPI

Sandhya Tiwade Kurian, M.D.

  • Family Medicine Physician
  • Kirkwood, MO
National Provider Identifier
1053555177
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017008412 Issued in MO
Practice address
10700 Manchester Rd Ste E
Kirkwood, MO 63122-1307
Phone
(314) 428-9541
NPI assigned
Apr 21, 2009
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 2017008412 MO Primary
Family Medicine Physician 207Q00000X 036-130438 IL

Addresses

Primary practice location

10700 Manchester Rd Ste E
Kirkwood, MO 63122-1307

Mailing address

10700 Manchester Rd Ste E
Kirkwood, MO 63122-1307
Phone (314) 428-9541

Other practice location 1

1 Professional Drive
Suite 220
Alton, IL 62002-5068
Phone (618) 463-8574

Other identifiers 1

IdentifierTypeStateIssuer
207219OtherILPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170419000471 MO Practitioner - Family Practice 2668643651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians
Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

2031 Zumbehl Rd
Saint Charles, MO 63303-2723
Phone (636) 206-2690

9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 961-2255

Merit-based Incentive Payment System (MIPS)

Final score
42.87 of 100Reported as group
Quality
31.86
Promoting interoperability
0
Improvement activities
40
Cost
61.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-130438ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Oct 1, 2024 Accepting new patients
Total Access Urgent Care, PC Family Medicine CurrentSince Apr 1, 2017 Accepting new patients
Total Access Urgent Care, PC CurrentSince Apr 1, 2017 Accepting new patients
Fairview Heights Medical Group SC Past Accepting new patients
Alton Memorial Physician Billing Services LLC PastSince Sep 1, 2018 Accepting new patients

Locations

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

2031 Zumbehl Rd
Saint Charles, MO 63303
Phone (636) 206-2690

10700 Manchester Rd
Ste E
Saint Louis, MO 63122
Phone (314) 428-9541

9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740

1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

13861 Manchester Rd
Wildwood, MO 63011
Phone (636) 220-9333

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1053555177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MANCHESTER RD STE E",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221307",
            "telephone_number": "314-428-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MANCHESTER RD STE E",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221307",
            "telephone_number": "314-428-9541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Professional Drive",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620025068",
            "country_code": "US",
            "telephone_number": "618-463-8574",
            "fax_number": "618-463-8688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURIAN",
        "first_name": "SANDHYA",
        "middle_name": "TIWADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017008412",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-130438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "207219",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

Verify at the official NPI Registry.