Active NPI
Emmanuel Ababio Agyemang, MD
- Hospitalist Physician
- Saint Louis, MO
National Provider Identifier
1235831975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2026034844
- Practice address
- 3015 N Ballas Rd
Saint Louis, MO 63131-2329 - Phone
- (314) 996-5772
- Fax
- (314) 996-7691
- NPI assigned
- Mar 20, 2023
- Last updated
- Aug 5, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA13036500 | NJ | |
| Hospitalist Physician | 208M00000X | 2026034844 | MO | Primary |
Addresses
Primary practice location
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Mailing address
PO Box 959354
Saint Louis, MO 63195-9354
Phone (314) 996-5772
Other practice location 1
201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7425
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA13036500 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Internal Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1235831975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 959354",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631959354",
"telephone_number": "314-996-5772",
"fax_number": "314-996-7691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 N BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312329",
"telephone_number": "314-996-5772",
"fax_number": "314-996-7691"
}
],
"practiceLocations": [
{
"address_1": "201 Lyons Ave",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "NJ",
"postal_code": "071122027",
"country_code": "US",
"telephone_number": "973-926-7425",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGYEMANG",
"first_name": "EMMANUEL",
"middle_name": "ABABIO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-20",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA13036500",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MO",
"license": "2026034844",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3015 N Ballas Rd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312329",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.