Individual provider Active NPI

Sandeep Hindupur, M.D.

  • Interventional Cardiology Physician
  • Saint Peters, MO
National Provider Identifier
1124164066
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2005025947 Issued in MO
Practice address
10 Hospital Dr Ste 100
Saint Peters, MO 63376-1659
Phone
(636) 916-7272
NPI assigned
Jan 29, 2007
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2005025947 MO
Cardiovascular Disease Physician 207RC0000X 2005025947 MO
Interventional Cardiology Physician 207RI0011X 2005025947 MO Primary

Addresses

Primary practice location

10 Hospital Dr Ste 100
Saint Peters, MO 63376-1659

Mailing address

10 Hospital Dr Ste 100
Saint Peters, MO 63376-1659
Phone (636) 916-7272

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110818000747 MO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2163692674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Missouri, Kansas City, School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Suite 100
Saint Peters, MO 63376-1659
Phone (636) 916-7272

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

1520 Wentzville Pkwy
Wentzville, MO 63385-3408
Phone (636) 497-4000

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005025947MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Physician Groups LC CurrentSince Jan 1, 2016 Accepting new patients

Locations

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

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

10 Hospital Dr
Ste 100
Saint Peters, MO 63376
Phone (636) 916-7272

Interoperability endpoints

  • Direct secure messaging: shindupur11399@direct.carenet.org

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Progress West HospitalO Fallon, MO, CCN 260219 Hospital Corporate Director
W-2 Managing Employee
Operational/Managerial Control
Jan 1, 2023
Jan 1, 2023
Jan 1, 2023

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1124164066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR STE 100",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761659",
            "telephone_number": "636-916-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR STE 100",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761659",
            "telephone_number": "636-916-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDUPUR",
        "first_name": "SANDEEP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2005025947",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2005025947",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2005025947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10 Hospital Dr Ste 100",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633761659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.