Individual provider Active NPI

Chaitanya Sugunasai Rojulpote

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1164042081
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2024047126 Issued in MO
Practice address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 617-2000
NPI assigned
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2024047126 MO
Hospitalist Physician 208M00000X 2024047126 MO
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2024047126 MO Primary

Addresses

Primary practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

501 S Washington Ave
Scranton, PA 18505-3814
Phone (570) 591-5175

Other practice location 1

501 S Washington Ave
Scranton, PA 18505-3814
Phone (570) 591-5175 ext. 1069

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
I20250327001101 MO Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9931518016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024047126MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince Mar 1, 2025 Accepting new patients
The Wright Center Medical Group Internal Medicine CurrentSince Feb 24, 2022 Accepting new patients

Locations

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

501 S Washington Ave
Scranton, PA 18505
Phone (570) 591-5153

Interoperability endpoints

  • Direct secure messaging: crojulpote454221@direct-ehr-ssmhc.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1164042081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S WASHINGTON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185053814",
            "telephone_number": "570-591-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185053814",
            "country_code": "US",
            "telephone_number": "570-591-5175 x1069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROJULPOTE",
        "first_name": "CHAITANYA",
        "middle_name": "SUGUNASAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2024047126",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2024047126",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2024047126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.