Active NPI
Sushant Koirala, MD
- Cardiovascular Disease Physician
- Saint Louis, MO
National Provider Identifier
1194464636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 2025019764
- Practice address
- 1201 S Grand Blvd
Saint Louis, MO 63104-1016 - Phone
- (314) 257-8000
- NPI assigned
- Jun 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 2025019764 | MO | Primary |
Addresses
Primary practice location
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Mailing address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (312) 942-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220811003328 | IL | Order and Referring Only - Internal Medicine | 8325421183 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025019764 | MO | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1194464636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016",
"telephone_number": "312-942-5000"
},
{
"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": "314-257-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOIRALA",
"first_name": "SUSHANT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-02",
"last_updated": "2025-06-24",
"certification_date": "2025-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MO",
"license": "2025019764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.