NPIMap

Individual provider Active NPI

Meher S Mallick, M.D.

  • Nephrology Physician
  • Saint Louis, MO
National Provider Identifier
1093789034
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2001009904 Issued in MO
Practice address
10004 Kennerly Rd Ste 361B
Saint Louis, MO 63128-2141
Phone
(314) 843-3449
Fax
(314) 843-8762
NPI assigned
Feb 15, 2006
Last updated
May 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2001009904 MO
Nephrology Physician 207RN0300X 2001009904 MO Primary
Nephrology Physician 207RN0300X 036.099093 IL

Addresses

Primary practice location

10004 Kennerly Rd Ste 361B
Saint Louis, MO 63128-2141

Mailing address

PO Box 840132
Kansas City, MO 64184-0132
Phone (314) 843-3449

Other practice location 1

1400 LeMay Ferry Rd
Saint Louis, MO 63125-2408
Phone (314) 685-8721

Other practice location 2

1300 N Market St
Sparta, IL 62286-1048
Phone (618) 443-4138

Other identifiers 4

IdentifierTypeStateIssuer
036099093MedicaidIL
6317901MedicaidIL
000013440OtherMEDICARE PTAN
390007770OtherRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nch@spartahospital.hin.us

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050303000513 IL Practitioner - Nephrology 7911950852 Reassigns benefits to 6 organizations
I20100225000946 MO Practitioner - NephrologyPractitioner - Internal Medicine 7911950852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Medical Clinic, P.C.Group PAC ID 2961496765, 11 clinicians
Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, shared by 35 NPIs, 117 clinicians
Rashid a Dalal MD PCGroup PAC ID 2163459348, 5 clinicians

Practice addresses (Care Compare)

1300 N Market St
Sparta, IL 62286-1048
Phone (618) 443-4138

1400 Lemay Ferry Rd
Saint Louis, MO 63125-2408
Phone (314) 432-1111

203 E Grant St
Coulterville, IL 62237-1623
Phone (618) 758-2331

2041 Goose Lake Rd
Sauget, IL 62206-2822

2071 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 857-2700

350 W S 1St St
Red Bud, IL 62278-1116
Phone (618) 282-5402

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (314) 628-7750

5003 N Illinois St
Suite 1
Fairview Heights, IL 62208-3419
Phone (618) 239-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.099093ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rashid a Dalal MD PC Nephrology CurrentSince May 9, 2024 Accepting new patients
Sparta Community Hospital D/B/a Quality Healthcare Clinics CurrentSince Apr 1, 2024 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Apr 1, 2024 Accepting new patients
St Louis Medical Clinic, P.C. CurrentSince May 2, 2025 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Southern Illinois Healthcare Foundation, Inc. CurrentSince Dec 19, 2020 Accepting new patients
Southern Illinois Healthcare Foundation Inc Current Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Dec 19, 2020 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Specialist Current Accepting new patients
Renal Alliance, LLC Nephrology Past Accepting new patients
Sparta Community Hospital D/B/a Quality Healthcare Clinics Past Accepting new patients
Sparta Community Hospital D/B/a Quality Healthcare Clinics Past Accepting new patients

Locations

129 N 8th St
East Saint Louis, IL 62201
Phone (617) 274-1905

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

5003 N Illinois St
#1
Fairview Heights, IL 62208
Phone (618) 235-5945

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

350 W South 1st St
Red Bud, IL 62278
Phone (618) 282-3891

325 Spring St
Redbud, IL 62278
Phone (618) 282-5165

2071 Goose Lake Rd
Sauget, IL 62206
Phone (314) 872-1473

1300 N Market St
Sparta, IL 62286
Phone (618) 443-4138

207 S Burns Ave
Sparta, IL 62286
Phone (618) 443-3084

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955

3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131
Phone (314) 270-1796

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDDCDD
  • Direct secure messaging: meher.mallick.1@27782.direct.athenahealth.com
  • Direct secure messaging: meher.mallick.1@9559.direct.athenahealth.com
  • Direct secure messaging: nch@spartahospital.hin.us

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 9

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1093789034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840132",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641840132",
            "telephone_number": "314-843-3449",
            "fax_number": "314-843-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 361B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-843-3449",
            "fax_number": "314-843-8762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 LeMay Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631252408",
            "country_code": "US",
            "telephone_number": "314-685-8721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 N Market St",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "IL",
            "postal_code": "622861048",
            "country_code": "US",
            "telephone_number": "618-443-4138",
            "fax_number": "618-443-3327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "MEHER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2001009904",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2001009904",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036.099093",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099093",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6317901",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000013440",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390007770",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nch@spartahospital.hin.us",
            "affiliation": "N",
            "address_1": "1300 N Market St",
            "city": "Sparta",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622861048",
            "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.