NPIMap

Individual provider Active NPI

Bala Sudhakar Reddy Allam, M.D.

  • Hospitalist Physician
  • Springfield, MO
National Provider Identifier
1104024231
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2010018938 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-2600
Fax
(417) 820-2100
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT189901 PA
Internal Medicine Physician 207R00000X 2010018938 MO
Hospitalist Physician 208M00000X 2010018938 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 4

IdentifierTypeStateIssuer
431560263OtherTRICARE WEST
183039001MedicaidAR
P00852017OtherRAILROAD MEDICARE GROUP CB9013
1104024231MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000936 MO Practitioner - HospitalistPractitioner - Internal Medicine 9638203334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

1605 Martin Springs Dr
Rolla, MO 65401-2980

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

  • Integrity Home Care + Hospice Hospice, Springfield, MO, CCN 261646
  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010018938MOMDHospitalist Physician
MT189901PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Internal Medicine CurrentSince Jul 1, 2010 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 1, 2013 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 1, 2010 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Mercy Hospital Springfield Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
#4C
Springfield, MO 65804

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Clinic Family Medicine - SteelvilleSteelville, MO, CCN 263850 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic - St. JamesSaint James, MO, CCN 263943 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic - St. RobertSaint Robert, MO, CCN 263813 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Pediatrics-RollaRolla, MO, CCN 268935 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine - Mountain GroveMountain Grove, MO, CCN 263840 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine-Branson WestBranson West, MO, CCN 263918 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine- CassvilleCassville, MO, CCN 263909 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine-El Dorado SpringsEl Dorado Springs, MO, CCN 263900 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Pediatrics-LebanonLebanon, MO, CCN 263831 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine-BuffaloBuffalo, MO, CCN 263921 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic-Lebanon-Family MedicineLebanon, MO, CCN 263814 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine-RichlandRichland, MO, CCN 263934 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic - Birch TreeBirch Tree, MO, CCN 263806 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic -SalemSalem, MO, CCN 263870 Rural health clinic Corporate Director Jul 1, 2018
Mercy Clinic Family Medicine-Mountain ViewMountain View, MO, CCN 263819 Rural health clinic Corporate Director Jul 1, 2018

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Organizations & group practices 5

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1104024231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2600",
            "fax_number": "417-820-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLAM",
        "first_name": "BALA SUDHAKAR REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT189901",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2010018938",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2010018938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183039001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP CB9013",
            "identifier": "P00852017",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104024231",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.