Nishant Poddar, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

2012034335 Issued in MO

Practice address

15945 Clayton Rd Ste 120
Ballwin, MO 63011-2490

Phone

(636) 256-5000

NPI assigned

May 3, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npoddar654208@direct.carenet.org

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  Medicare reassignment NPD
• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment NPD
• Southern Illinois Medical Services, NFP

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • O Fallon, IL
  • NPI 1477076263
  Medicare reassignment NPD
• Ozarks Medical Center

  • Psychiatric Hospital Unit
  • West Plains, MO
  • NPI 1235929027
  NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1457203135
  NPD
• Washington University Physicians in Illinois, Inc.

  • Multi-Specialty Clinic/Center
  • O Fallon, IL
  • NPI 1528569845
  NPD

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1124387675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13125 BELLERIVE FARM DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD STE 120",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112490",
            "telephone_number": "636-256-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pin Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Carterville",
            "state": "IL",
            "postal_code": "629181600",
            "country_code": "US",
            "telephone_number": "618-985-3333",
            "fax_number": "618-985-1318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PODDAR",
        "first_name": "NISHANT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "2012034335",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036147565",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036147565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200001507",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1418 Cross St",
            "address_2": "Div IM Medical Oncology, Ste 180",
            "city": "Shiloh",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622692988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Physical Therapy Spine & Sports Medicine LLC
• Amanda Pickett
• Jerry M Pierson, PT
• Elizabeth Pitcher, OTR/L
• Plaza Orthodontics
• Polished - Melissa a Smith DDS PC
• Kevin Ferguson Postol, DDS
• Preferred Hospice of Missouri Northeast LLC
• Premier Healthcare STL LLC
• Daniel Thomas Price, RPH

• Medical Oncology Physician in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Medical Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.