Individual provider Active NPI

Asif Bhutto, M.D.

  • Internal Medicine Physician
  • Bridgeton, MO
National Provider Identifier
1205093473
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2008007521 Issued in MO
Practice address
3466 Bridgeland Dr Ste 105
Bridgeton, MO 63044-2606
Phone
(314) 209-5100
NPI assigned
May 16, 2008
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2008007521 MO Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2004-012733 MO
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2008007521 MO

Addresses

Primary practice location

3466 Bridgeland Dr Ste 105
Bridgeton, MO 63044-2606

Mailing address

PO Box 8356
Saint Louis, MO 63132-0356
Phone (314) 977-8462

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
I20080707000307 MO Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0648342717 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Practice addresses (Care Compare)

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

3466 Bridgeland Dr
Suite 150
Bridgeton, MO 63044-2606
Phone (314) 219-7420

6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone (314) 768-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-012733MOMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialist in Aging Successfully LLC Geriatric Medicine CurrentSince Jan 1, 2019 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Mar 3, 2019 Accepting new patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Inpatient Consultants of Missouri Inc Internal Medicine Past Accepting new patients

Locations

12255 De Paul Dr
Ste 260
Bridgeton, MO 63044
Phone (314) 209-5100

12255 De Paul Dr
Ste 600
Bridgeton, MO 63044
Phone (314) 209-5100

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

3466 Bridgeland Dr
Ste 105
Bridgeton, MO 63044
Phone (314) 209-5100

3466 Bridgeland Dr
Ste 150
Bridgeton, MO 63044
Phone (314) 209-8222

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

522 N New Ballas Rd
Ste 210
Saint Louis, MO 63141
Phone (314) 219-7420

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

Interoperability endpoints

  • Direct secure messaging: abhutto1097@direct-ehr-ssmhc.com

Organizations & group practices 6

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1205093473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8356",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631320356",
            "telephone_number": "314-977-8462",
            "fax_number": "314-771-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3466 BRIDGELAND DR STE 105",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442606",
            "telephone_number": "314-209-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUTTO",
        "first_name": "ASIF",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2008007521",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2004-012733",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2008007521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.