Individual provider Active NPI

Ali Akbar Mehdirad, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Saint Louis, MO
National Provider Identifier
1093770257
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
R5G76 Issued in MO
Practice address
777 S New Ballas Rd
Suite 300E
Saint Louis, MO 63141-8705
Phone
(314) 432-7839
Fax
(314) 432-4839
NPI assigned
Apr 19, 2006
Last updated
Jul 13, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X R5G76 MO Primary

Addresses

Primary practice location

777 S New Ballas Rd
Suite 300E
Saint Louis, MO 63141-8705

Mailing address

PO Box 952273
Saint Louis, MO 63195-2273
Phone (314) 432-2580

Other identifiers 3

IdentifierTypeStateIssuer
431908828OtherMOTAX ID#
505207209MedicaidMO
CH4229OtherMORR MEDICARE GROUP#

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
I20100812000510 MO Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 6608879234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R5G76MOMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Py Medical Services of Mo PC CurrentSince Jan 1, 2025 Accepting new patients
Midwest Heart Rhythm Incorporated Clinical Cardiac Electrophysiology PastSince Dec 27, 2000 Accepting new patients

Locations

10954 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 843-4242

2939 Magazine St
Saint Louis, MO 63106
Phone (314) 531-0500

110 Highland Ave
Valley Park, MO 63088
Phone (636) 225-5144

3438 Bell Blvd
Ste 301
Bayside, NY 11361

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1093770257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952273",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952273",
            "telephone_number": "314-432-2580",
            "fax_number": "314-432-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "SUITE 300E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-432-7839",
            "fax_number": "314-432-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHDIRAD",
        "first_name": "ALI",
        "middle_name": "AKBAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MO",
            "license": "R5G76",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "431908828",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505207209",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP#",
            "identifier": "CH4229",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.