Individual provider Active NPI

Lalithkumar K Chouhan, MD

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1124011028
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
R2E98 Issued in MO
Practice address
11125 Dunn Rd
Ste 204
Saint Louis, MO 63136-6132
Phone
(314) 839-5522
Fax
(314) 839-5351
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036073350 IL
Cardiovascular Disease Physician 207RC0000X R2E98 MO Primary

Addresses

Primary practice location

11125 Dunn Rd
Ste 204
Saint Louis, MO 63136-6132

Mailing address

11125 Dunn Rd
Ste 204
Saint Louis, MO 63136-6132
Phone (314) 839-5522

Other practice location 1

12255 De Paul Dr Ste 600
Bridgeton, MO 63044-2515
Phone (314) 770-9888

Other identifiers 13

IdentifierTypeStateIssuer
6287491OtherCIGNA
006029924OtherMOMORRMCR
5567V8816OtherHCUSA
229043OtherHLNK
2500129OtherUHC
27698OtherMOMOBS/BLCHOICE
F18347OtherMERCY
000000012519OtherESSENCE
060067892OtherILILRRMCR
203348701MedicaidMO
431098908OtherTRICARE
1455V3831OtherGHP/CMR
4379428OtherAETNA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lchouhan16057@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE) Christian Hospital Northeast- Northwest

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 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
I20090513000220 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1850284498 Reassigns benefits to 3 organizations
I20101026001463 IL Practitioner - Cardiovascular Disease (Cardiology) 1850284498 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alton Memorial Physician Billing Services LLCGroup PAC ID 9436389442, 11 clinicians
Christian Hospital Physician Billing Services LLCGroup PAC ID 4284796913, 11 clinicians
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1 Memorial Dr Administration
Alton, IL 62002-6722

11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6188
Phone (314) 839-5522

12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2515
Phone (314) 209-5100

2 Memorial Dr
Suite 122
Alton, IL 62002-6723
Phone (618) 462-6612

Hospital & facility affiliations

  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • Memorial Hospital Hospital, Belleville, IL, CCN 140185

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alton Memorial Physician Billing Services LLC CurrentSince Sep 10, 2019 Accepting new patients
SSM Medical Group, Inc. Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St Louis Cardiovascular Disease CurrentSince Jan 1, 2016 Accepting new patients
Christian Hospital Physician Billing Services LLC Cardiovascular Disease CurrentSince Nov 1, 2019 Accepting new patients
Osf Healthcare System CurrentSince Nov 1, 2014 Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
Saint Anthony'S Physician Group Past Accepting new patients
Alton Memorial Physician Billing Services, LLC Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

2 Memorial Dr
Ste 102
Alton, IL 62002
Phone (618) 288-0900

2 Memorial Dr
Ste 122
Alton, IL 62002
Phone (618) 462-6612

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

12255 De Paul Dr
Ste 600
Bridgeton, MO 63044
Phone (314) 209-5100

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

300 Medical Plz
Ste 221
Lake St Louis, MO 63367
Phone (636) 561-2229

2920 Fee Fee Rd
Maryland Hts, MO 63043
Phone (314) 291-0121

2963 Doddridge Ave
Maryland Hts, MO 63043
Phone (314) 291-3909

1002 Peruque Crossing Ct
Ste 101
O Fallon, MO 63366
Phone (636) 294-5900

400 1st Capitol Dr
Ste 401
Saint Charles, MO 63301
Phone (314) 946-8700

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

11133 Dunn Rd
Ste 2346
Saint Louis, MO 63136
Phone (314) 653-5125

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

11125 Dunn Rd
Ste 204
Saint Louis, MO 63136
Phone (314) 355-2300

Interoperability endpoints

  • Direct secure messaging: lchouhan16057@direct-ehr-ssmhc.com
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 10

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 7

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.

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1124011028",
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        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
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            "address_2": "STE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
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            "telephone_number": "314-839-5522",
            "fax_number": "314-839-5351"
        },
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            "telephone_number": "314-839-5522",
            "fax_number": "314-839-5351"
        }
    ],
    "practiceLocations": [
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            "address_1": "12255 De Paul Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442515",
            "country_code": "US",
            "telephone_number": "314-770-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUHAN",
        "first_name": "LALITHKUMAR",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036073350",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "R2E98",
            "primary": true
        }
    ],
    "identifiers": [
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            "desc": "Other (non-Medicare)",
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            "state": null
        },
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            "code": "01",
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        {
            "code": "01",
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            "identifier": "5567V8816",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLNK",
            "identifier": "229043",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2500129",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOBS/BLCHOICE",
            "identifier": "27698",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "F18347",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000012519",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILRRMCR",
            "identifier": "060067892",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203348701",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431098908",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP/CMR",
            "identifier": "1455V3831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4379428",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lchouhan16057@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lchouhan16057@direct-ehr-ssmhc.com",
            "address_1": "12255 De Paul Dr Ste 600",
            "city": "Bridgeton",
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            "country_code": "US",
            "postal_code": "630442515",
            "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": "12255 De Paul Dr Ste 600",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Christian Hospital Northeast- Northwest",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11125 Dunn Rd",
            "address_2": "Ste 204",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366132",
            "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.