Gateway Hospitalist PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2000160353 Issued in MO

Legal business name

GATEWAY HOSPITALIST PC

Practice address

4455 Duncan Ave
Saint Louis, MO 63110-1111

Phone

(314) 658-3800

Fax

(636) 333-4510

NPI assigned

Jun 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mohammed Haque, MDNPI 1689604100

Title

Owner

Phone

(314) 713-3665

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammed Mominul Haque, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1689604100
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701561600000",
    "number": "1225072671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630430449",
            "telephone_number": "314-713-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 DUNCAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101111",
            "telephone_number": "314-658-3800",
            "fax_number": "636-333-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY HOSPITALIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2023-12-03",
        "certification_date": "2023-12-03",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-713-3665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2000160353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507420701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gateway Geriatric Services LLC
• Gateway Givers LLC
• Gateway Health Care Inc
• Gateway Health Medical Group PC
• Gateway Home Health Care LLC
• Gateway Housing Foundation
• Gateway Iom, LLC
• Gateway Low Vision LLC
• Gateway Mental Wellness (Gateway Life Counseling)
• Gateway Nephrology Corp

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2023; 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.

Verify at the official NPI Registry.