Individual provider Active NPI

Ghandi Hassan, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1073409207
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2025021646 Issued in MO
Practice address
4590 Nash Way
Saint Louis, MO 63110-1020
Phone
(314) 454-8087
NPI assigned
Jun 16, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 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 2025021646 MO Primary

Addresses

Primary practice location

4590 Nash Way
Saint Louis, MO 63110-1020

Mailing address

4949 W Pine Blvd Apt 12a
Saint Louis, MO 63108-1476
Phone (314) 309-9444

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
I20250623002190 MO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1355853706

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1073409207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 W PINE BLVD APT 12A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081476",
            "telephone_number": "314-309-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 NASH WAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101020",
            "telephone_number": "314-454-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "GHANDI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025021646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.