Infectious Disease

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

108767 Issued in MO

Legal business name

INFECTIOUS DISEASE

Practice address

10004 Kennerly Rd Ste 295B
Saint Louis, MO 63128-2177

Phone

(314) 740-2949

Fax

(314) 375-5020

NPI assigned

Jan 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Suresh Nellore, MDNPI 1144297862

Title

MD

Phone

(314) 740-2949

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suresh Nellore, MD

  • Infectious Disease Physician
  • Saint Louis, MO
  • NPI 1144297862
  Medicare reassignment Care Compare group NPD Authorized official
• Swati Patolia

  • Infectious Disease Physician
  • St Louis, MO
  • NPI 1982952560
  Medicare reassignment Care Compare group NPD
• Ayesha Soomro, M.D.

  • Infectious Disease Physician
  • Saint Louis, MO
  • NPI 1518318567
  Medicare reassignment Care Compare group NPD
• Ali Etemady-Deylamy

  • Infectious Disease Physician
  • Saint Louis, MO
  • NPI 1760864888
  Medicare reassignment NPD
• Amber Mahmood Bokhari, MD

  • Infectious Disease Physician
  • Saint Louis, MO
  • NPI 1457864175
  Care Compare group
• Alexander K Mammen, M.D.

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1609874734
  NPD (past)

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1225494628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 KENNERLY RD",
            "address_2": "295B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-740-2949",
            "fax_number": "314-375-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 295B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282177",
            "telephone_number": "314-740-2949",
            "fax_number": "314-375-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "NELLORE",
        "authorized_official_first_name": "SURESH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "314-740-2949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "108767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Life, LLC
• Independent Living at It'S Best, LLC
• Independent Living Home Care LLC
• Inderjit Singh MD Facp LLC
• Indvidualized Therapy & Care, P.C.
• Infectious Disease Consultants, Inc.
• Infectious Disease Physicians LLC
• Infectious Disease, PC
• Infectious Diseases Consultants LLC
• Infectious Diseases PC

• Infectious Disease Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Infectious Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.

Verify at the official NPI Registry.