Individual provider Active NPI

Hassan R Jafri, PT, DPT

  • Geriatric Physical Therapist
  • St. Louis, MO
National Provider Identifier
1194067116
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
2012012469 Issued in MO
Practice address
1722 Olive
Sutie 201
St. Louis, MO 63103
Phone
(314) 467-8506
NPI assigned
Mar 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 2012012469 MO Primary
Sports Physical Therapist 2251S0007X 2012012469 MO
Orthopedic Physical Therapist 2251X0800X 2012012469 MO

Addresses

Primary practice location

1722 Olive
Sutie 201
St. Louis, MO 63103

Mailing address

1722 Olive
#201 (Invigorate Rehab)
St. Louis, MO 63103
Phone (314) 467-8506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130423000045 MO Practitioner - Physical Therapist in Private Practice 4688810518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yam Medical Center LLCGroup PAC ID 8123445764, 4 clinicians

Practice addresses (Care Compare)

12800 Boenker LN
Bridgeton, MO 63044-2438
Phone (314) 499-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yam Medical Center LLC Geriatrics CurrentSince Aug 18, 2020 Accepting new patients
Invigorate Rehab Inc Geriatrics CurrentSince Jan 28, 2013 Accepting new patients
Yam Home Health LLC CurrentSince Mar 12, 2020 Accepting new patients

Locations

12800 Boenker Ln
Bridgeton, MO 63044
Phone (314) 499-6060

1722 Olive St
Ste 201
Saint Louis, MO 63103
Phone (314) 467-8506

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
Yam Home Health LLCBridgeton, MO, CCN 267674 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Corporate Director
Nov 8, 2019
Nov 8, 2019
Nov 8, 2019

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 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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1194067116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 OLIVE",
            "address_2": "#201 (INVIGORATE REHAB)",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63103",
            "telephone_number": "314-467-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 OLIVE",
            "address_2": "SUTIE 201",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63103",
            "telephone_number": "314-467-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFRI",
        "first_name": "HASSAN",
        "middle_name": "R",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MO",
            "license": "2012012469",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MO",
            "license": "2012012469",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2012012469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

Verify at the official NPI Registry.