Individual provider Active NPI

Natalya Rukhman, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Louis, MO
National Provider Identifier
1063616506
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2011002817 Issued in MO
Practice address
621 S New Ballas Rd
Suite 460a
Saint Louis, MO 63141-8232
Phone
(314) 251-4330
Fax
(314) 251-4333
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2011002817 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 460a
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Suite 460a
Saint Louis, MO 63141-8232
Phone (314) 251-4330

Other identifiers 1

IdentifierTypeStateIssuer
2011002817OtherMOMO LICENSE

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
I20120126000823 MO Practitioner - EndocrinologyPractitioner - Internal Medicine 0244407575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Endocrinology LLCGroup PAC ID 7416073531, 7 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 460a
Saint Louis, MO 63141-8259
Phone (314) 251-4330

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Aug 21, 2018 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 21, 2018 Accepting new patients
Mercy Clinic Endocrinology, LLC Endocrinology, Diabetes & Metabolism CurrentSince Aug 19, 2013 Accepting new patients

Locations

621 S New Ballas Rd
Ste 460A
Saint Louis, MO 63141
Phone (314) 251-4330

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Interoperability endpoints

  • Direct secure messaging: nrukhman365593@directc.mercy.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1063616506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 460A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-4330",
            "fax_number": "314-251-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 460A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-4330",
            "fax_number": "314-251-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUKHMAN",
        "first_name": "NATALYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2011002817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2011002817",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.