Mansoor Ul Haq, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

2017014864 Issued in MO

Practice address

1011 Bowles Ave Ste G50
Fenton, MO 63026-0562

Phone

(636) 496-4640

NPI assigned

Oct 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mansoor Ul Haq Other name

Electronic endpoints 2

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

Specialty

Hematology/Oncology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhaq209454@direct-ehr-ssmhc.com

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.

• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• SSM Health Care St. Louis

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922
  NPD (past)

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1336387836
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1962572396
  Care Compare affiliation

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1104079607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE G50",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630260562",
            "telephone_number": "636-496-4640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pin Oak Drive",
            "address_purpose": "LOCATION",
            "city": "Carterville",
            "state": "IL",
            "postal_code": "62918",
            "country_code": "US",
            "telephone_number": "618-985-3333",
            "fax_number": "618-985-1318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAQ",
        "first_name": "MANSOOR",
        "middle_name": "UL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036.135192",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "2017014864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhaq209454@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mhaq209454@direct-ehr-ssmhc.com",
            "address_1": "1011 Bowles Ave Ste G50",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630260562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1011 Bowles Ave Ste G50",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630260562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MANSOOR UL",
            "last_name": "HAQ",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cassandra A Halsted, DPT
• Taylor Halteman, DPT
• Mary M Hammel, FNP
• Joel Hammond, MD
• James Edwin Hanny, MA, MSC. CCC/SLP
• Tiffany Shanta Harold, APRN
• Darrel Alan Harris, R.N.
• Ryan Harris, FNP-C
• Amanda Haury, LPC
• Hawkins Heights Dental

• Hematology & Oncology Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Hematology & Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.