Individual provider Active NPI

Nishan Chobanian Jr., MD

  • Gynecologic Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1104813633
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
4301110735 Issued in MI
Practice address
607 S New Ballas Rd
Saint Louis, MO 63141-8222
Phone
(314) 251-4260
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 4301110735 MI Primary

Addresses

Primary practice location

607 S New Ballas Rd
Saint Louis, MO 63141-8222

Mailing address

22301 Foster Winter Dr
Southfield, MI 48075-3707
Phone (248) 849-8140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, MT2 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
I20220720002468 ME Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 4486620135
I20250619001195 MT Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 4486620135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.63 of 100Reported as group
Quality
77.69
Promoting interoperability
95
Improvement activities
40
Cost
78.59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corporation CurrentSince Jun 11, 2025 Accepting new patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Mercy Support Services Past Accepting new patients
St. John'S Mercy Support Services Past Accepting new patients
Baystate Medical Practices, Inc Past Accepting new patients

Locations

1200 Westwood Dr
Ste G
Hamilton, MT 59840
Phone (406) 375-4777

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

Interoperability endpoints

  • Direct secure messaging: nchobanian1689@directc.mercy.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1104813633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-849-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418222",
            "telephone_number": "314-251-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOBANIAN",
        "first_name": "NISHAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MI",
            "license": "4301110735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.