Rahul S Phatak, MD

Individual provider Active NPI Hospitalist Physician · Saint Louis, MO

NPI 1124086038 · NPPES record last updated Mar 3, 2021

Key facts

NPI
1124086038
Entity type
Individual (NPI type 1)
Primary specialty
Hospitalist Physician 208M00000X
License
2001009343 (MO)
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-5772
Fax
(314) 996-7691
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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 3

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

Medicare Care Compare profile

Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LC (526 clinicians)

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Hospital & facility affiliations

  • BJC Hospice Hospice · Saint Louis, MO · CCN 261511
  • Missouri Baptist Medical Center Hospital · Saint Louis, MO · CCN 260108
  • Barnes Jewish Hospital Hospital · Saint Louis, MO · CCN 260032

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041206001007 MO Practitioner - Internal Medicine 1658337290 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Current
since Sep 1, 2008
Accepting new patients
Physician Groups LC Current
since Sep 1, 2008
Accepting new patients
Sanjay a. Patwardhan, MD, PC Past Accepting new patients
BC Missouri Emergency Physicians, LLP Past Accepting new patients
Physician Groups LC Past Accepting new patients
Missouri Baptist Medical Center Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

Interoperability endpoints

  • Direct secure messaging: rphatak10947@direct.carenet.org
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2001009343 MO Yes

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Hospitalist Physician in Missouri

Sources for this page

Verify at the official NPI Registry.