Individual provider Active NPI

Afshan Sultana, MD

  • Child & Adolescent Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1073631099
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
04-34060 Issued in KS
Practice address
1 Childrens PL
Div Child and Adolescent Psychiatry
Saint Louis, MO 63110-1002
Phone
(314) 286-1700
Fax
(314) 286-1777
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2010003417 MO
Child & Adolescent Psychiatry Physician 2084P0804X 2010003417 MO
Psychiatry Physician 2084P0800X 04-34060 KS
Child & Adolescent Psychiatry Physician 2084P0804X 04-34060 KS Primary

Addresses

Primary practice location

1 Childrens PL
Div Child and Adolescent Psychiatry
Saint Louis, MO 63110-1002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 286-1700

Other identifiers 1

IdentifierTypeStateIssuer
200029613MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, KS2 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
I20120127000994 IL Practitioner - Psychiatry 1355508672 Reassigns benefits to 1 organization
I20231219000381 KS Practitioner - Psychiatry 1355508672 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-34060KSMDPsychiatry Physician
2010003417MOMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation Inc CurrentSince Jan 9, 2012 Accepting new patients
Southern Illinois Healthcare Foundation, Inc. CurrentSince Jan 9, 2012 Accepting new patients
Southern Illinois Healthcare Foundation Inc Current Accepting new patients

Locations

2 Terminal Dr
Ste 8
East Alton, IL 62024
Phone (618) 258-0485

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

Interoperability endpoints

  • Direct secure messaging: asultana746160@directc.mercy.net
  • Direct secure messaging: afshan.sultana.1@9559.direct.athenahealth.com
  • Direct secure messaging: asultana1240772@direct.carenet.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1073631099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-286-1700",
            "fax_number": "314-286-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV CHILD AND ADOLESCENT PSYCHIATRY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-286-1700",
            "fax_number": "314-286-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANA",
        "first_name": "AFSHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2010003417",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "2010003417",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04-34060",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KS",
            "license": "04-34060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200029613",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Child and Adolescent Psychiatry",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.