Individual provider Active NPI

Fariba Azarpour, M.D.

  • Pediatrics Physician
  • Saint Charles, MO
National Provider Identifier
1225099690
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R1H95 Issued in MO
Practice address
711 Veterans Memorial Pkwy Ste 200
Saint Charles, MO 63303-2106
Phone
(636) 669-2443
Fax
(636) 669-2390
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R1H95 MO Primary

Addresses

Primary practice location

711 Veterans Memorial Pkwy Ste 200
Saint Charles, MO 63303-2106

Mailing address

711 Veterans Memorial Pkwy Ste 200
Saint Charles, MO 63303-2106
Phone (636) 669-2243

Other identifiers 1

IdentifierTypeStateIssuer
209757824MedicaidMO

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
I20040913001386 MO Practitioner - Pediatric Medicine 0143297713 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

711 Veterans Memorial Pkwy
Ste 200
Saint Charles, MO 63303
Phone (636) 379-6363

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

Organizations & group practices 1

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225099690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 VETERANS MEMORIAL PKWY STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032106",
            "telephone_number": "636-669-2243",
            "fax_number": "636-669-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 VETERANS MEMORIAL PKWY STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032106",
            "telephone_number": "636-669-2443",
            "fax_number": "636-669-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZARPOUR",
        "first_name": "FARIBA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R1H95",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209757824",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.