Individual provider Active NPI

Farhat Shereen, MD

  • Rheumatology Physician
  • Lake Saint Louis, MO
National Provider Identifier
1255583407
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2004017395 Issued in MO
Practice address
300 Medical PLZ
Ste. 100
Lake Saint Louis, MO 63367-1481
Phone
(636) 625-8300
Fax
(636) 625-8301
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2004017395 MO Primary

Addresses

Primary practice location

300 Medical PLZ
Ste. 100
Lake Saint Louis, MO 63367-1481

Mailing address

300 Medical PLZ
Ste. 100
Lake Saint Louis, MO 63367-1481
Phone (636) 625-8300

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
I20090224000358 MO Practitioner - Internal MedicinePractitioner - Rheumatology 9032274154

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Rheumatology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 Progress Point Pkwy
Suite 106
O Fallon, MO 63368-2207
Phone (636) 625-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004017395MOMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ali Medical LLC Rheumatology CurrentSince Jun 1, 2012 Accepting new patients
Ali Rheumatology, LLC Rheumatology PastSince Aug 1, 2010 Accepting new patients
Ozarks Medical Center Rheumatology Past Accepting new patients

Locations

300 Medical Plz
Ste 100
Lake St Louis, MO 63367
Phone (636) 625-8300

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1255583407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "address_2": "STE. 100",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671481",
            "telephone_number": "636-625-8300",
            "fax_number": "636-625-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "address_2": "STE. 100",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671481",
            "telephone_number": "636-625-8300",
            "fax_number": "636-625-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEREEN",
        "first_name": "FARHAT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "2004017395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.