Individual provider Active NPI

Puja Gurung, M.D.

  • Sleep Medicine (Family Medicine) Physician
  • Alton, IL
National Provider Identifier
1063727832
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X
License
036131486 Issued in IL
Practice address
4 Memorial Dr Ste 230
Alton, IL 62002-6704
Phone
(618) 433-6616
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Family Medicine) Physician 207QS1201X 2013010523 MO
Sleep Medicine (Family Medicine) Physician 207QS1201X 036131486 IL Primary

Addresses

Primary practice location

4 Memorial Dr Ste 230
Alton, IL 62002-6704

Mailing address

4 Memorial Dr Ste 230
Alton, IL 62002-6704
Phone (618) 433-6616

Other practice location 1

1225 Graham Rd Ste 1220B
Florissant, MO 63031-8012
Phone (618) 466-6616

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130618000142 IL Practitioner - Sleep MedicinePractitioner - Family PracticePractitioner - Hospitalist 1355580648 Reassigns benefits to 1 organization
I20211008001543 MO Practitioner - Sleep MedicinePractitioner - Family Practice 1355580648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1225 Graham Rd
Suite C 2310
Florissant, MO 63031-8023
Phone (314) 953-6300

2 Memorial Dr
Suite 220
Alton, IL 62002-6723
Phone (618) 474-1723

Hospital & facility affiliations

  • Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Jul 1, 2013 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jul 1, 2013 Accepting new patients

Locations

4 Memorial Dr
Ste 230
Alton, IL 62002
Phone (618) 463-7874

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1225 Graham Rd
Ste 1220B
Florissant, MO 63031
Phone (314) 953-8250

1225 Graham Rd
Ste C-2310
Florissant, MO 63031
Phone (314) 953-6300

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784

Organizations & group practices 2

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 4

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": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1063727832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 230",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-433-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 230",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-433-6616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Graham Rd Ste 1220B",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630318012",
            "country_code": "US",
            "telephone_number": "618-466-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURUNG",
        "first_name": "PUJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "MO",
            "license": "2013010523",
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "IL",
            "license": "036131486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4 Memorial Dr Ste 230",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.