Individual provider Active NPI

Syeda Rumana Ishrat, MD

  • Internal Medicine Physician
  • Hazelwood, MO
National Provider Identifier
1063998953
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2024048904 Issued in MO
Practice address
801 Hazelwest Dr
Hazelwood, MO 63042-1754
Phone
(314) 919-2700
Fax
(314) 919-2777
NPI assigned
Jul 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2024048904 MO Primary

Addresses

Primary practice location

801 Hazelwest Dr
Hazelwood, MO 63042-1754

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (314) 919-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, 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
I20221115002277 NY Practitioner - Internal Medicine 7315291622 Reassigns benefits to 1 organization
I20250314000421 MO Practitioner - Internal Medicine 7315291622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

801 Hazelwest Dr
Hazelwood, MO 63042-1754
Phone (314) 919-2700

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024048904MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jan 4, 2025 Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Jul 27, 2022 Accepting new patients

Locations

801 Hazelwest Dr
Hazelwood, MO 63042
Phone (314) 919-2700

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

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 2

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": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1063998953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "314-919-2700",
            "fax_number": "314-919-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HAZELWEST DR",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421754",
            "telephone_number": "314-919-2700",
            "fax_number": "314-919-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHRAT",
        "first_name": "SYEDA RUMANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-14",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2024048904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

Verify at the official NPI Registry.