Individual provider Active NPI

Ilke Nalbantoglu, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1124261342
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2010019735 Issued in MO
Practice address
216 S Kingshighway Blvd
Saint Louis, MO 63110-1026
Phone
(314) 362-5641
Fax
(314) 362-0369
NPI assigned
Apr 17, 2009
Last updated
Jan 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2010019735 MO Primary

Addresses

Primary practice location

216 S Kingshighway Blvd
Saint Louis, MO 63110-1026

Mailing address

660 S Euclid Ave
C B 8118
Saint Louis, MO 63110-1010
Phone (314) 362-5641

Other identifiers 2

IdentifierTypeStateIssuer
1124261342MedicaidMO
ENROLLEDMedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20171121002804 CT Practitioner - Pathology 1951425958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 785-4638

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010019735MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Oct 31, 2017 Accepting new patients
Yale University CurrentSince Oct 31, 2017 Accepting new patients

Locations

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1124261342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8118",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-5641",
            "fax_number": "314-362-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101026",
            "telephone_number": "314-362-5641",
            "fax_number": "314-362-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALBANTOGLU",
        "first_name": "ILKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2010019735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124261342",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.