Individual provider Active NPI

Sumanth Damodar Prabhu, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Saint Louis, MO
National Provider Identifier
1265417992
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
2021038192 Issued in MO
Practice address
4921 Parkview PL
Div Im Cardiology, Ste 8B
Saint Louis, MO 63110-1032
Phone
(314) 362-1291
Fax
(314) 362-4278
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2021038192 MO
Cardiovascular Disease Physician 207RC0000X 2021038192 MO
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 2021038192 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Div Im Cardiology, Ste 8B
Saint Louis, MO 63110-1032

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-1291

Other identifiers 1

IdentifierTypeStateIssuer
200102839MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120203000273 AL Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9739210972 Reassigns benefits to 1 organization
I20211202001651 MO Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9739210972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

4500 Forest Park Ave
Saint Louis, MO 63108-2114

4921 Parkview PL
Saint Louis, MO 63110-1032

Hospital & facility affiliations

  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Dec 26, 2011 Accepting new patients
Heart Care Institute LLC CurrentSince Dec 16, 2021 Accepting new patients
Heart Care Institute LLC CurrentSince Dec 16, 2021 Accepting new patients
University Medical Services Foundation Inc Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients
University Medical Associates Internal Medicine Past Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

1020 N Mason Rd
Ste 210
Saint Louis, MO 63141
Phone (314) 996-3162

Organizations & group practices 7

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 2

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1265417992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-1291",
            "fax_number": "314-362-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DIV IM CARDIOLOGY, STE 8B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-1291",
            "fax_number": "314-362-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "SUMANTH",
        "middle_name": "DAMODAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2021038192",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2021038192",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "MO",
            "license": "2021038192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200102839",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Div IM Cardiology, Ste 8B",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.