Individual provider Active NPI

Siroth Charnond, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1265421218
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.150546 Issued in IL
Practice address
3451 Union Blvd
Saint Louis, MO 63115-1142
Phone
(314) 888-0970
Fax
(314) 408-7063
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 108377 MO
Internal Medicine Physician 207R00000X 036.150546 IL Primary

Addresses

Primary practice location

3451 Union Blvd
Saint Louis, MO 63115-1142

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (314) 888-0970

Other practice location 1

7421 S Outer 364
Dardenne Prairie, MO 63368-7014
Phone (636) 561-8100

Other practice location 2

8033 W Florissant Ave Ste A
Jennings, MO 63136-1412
Phone (314) 888-0971

Other practice location 3

3863A Gravois Ave
Saint Louis, MO 63116-4657
Phone (314) 888-0981

Other practice location 4

16659 E 23rd St S
Independence, MO 64055-1922
Phone (816) 688-6000

Other practice location 5

2420 State St
East Saint Louis, IL 62205-2321
Phone (618) 318-8809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 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
I20100818000515 MO Practitioner - Internal Medicine 3779617352 Reassigns benefits to 1 organization
I20211122000121 IL Practitioner - Internal Medicine 3779617352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group of Missouri LLCGroup PAC ID 7315340213, 25 clinicians

Practice addresses (Care Compare)

8033 W Florissant Ave a
Oak Street Health Jennings
Jennings, MO 63136-1412
Phone (314) 888-0971

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.150546ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Missouri, LLC Internal Medicine CurrentSince Nov 29, 2021 Accepting new patients
Osh-Il Physicians Group LLC Internal Medicine CurrentSince Nov 29, 2021 Accepting new patients
Crestview Medical Associates, LLC Internal Medicine Past Accepting new patients
Oak Street Health Physicians Group, PC Internal Medicine PastSince Nov 29, 2021 Accepting new patients

Locations

2420 State St
East Saint Louis, IL 62205
Phone (618) 318-8809

16659 E 23rd St S
Independence, MO 64055
Phone (816) 688-6000

3451 Union Blvd
Saint Louis, MO 63115
Phone (314) 390-9890

3843 Gravois Ave
Saint Louis, MO 63116
Phone (314) 888-0981

8033 West Florissant Ave
Ste A
Saint Louis, MO 63136
Phone (314) 888-0971

Interoperability endpoints

  • Direct secure messaging: sirothcharnond@ihadv.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1265421218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "314-888-0970",
            "fax_number": "314-408-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 UNION BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631151142",
            "telephone_number": "314-888-0970",
            "fax_number": "314-408-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7421 S OUTER 364",
            "address_purpose": "LOCATION",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633687014",
            "country_code": "US",
            "telephone_number": "636-561-8100",
            "fax_number": "636-561-3396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8033 W Florissant Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Jennings",
            "state": "MO",
            "postal_code": "631361412",
            "country_code": "US",
            "telephone_number": "314-888-0971",
            "fax_number": "314-408-7062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3863A Gravois Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631164657",
            "country_code": "US",
            "telephone_number": "314-888-0981",
            "fax_number": "314-442-7794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16659 E 23rd St S",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640551922",
            "country_code": "US",
            "telephone_number": "816-688-6000",
            "fax_number": "816-631-1885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2420 State St",
            "address_purpose": "LOCATION",
            "city": "East Saint Louis",
            "state": "IL",
            "postal_code": "622052321",
            "country_code": "US",
            "telephone_number": "618-318-8809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARNOND",
        "first_name": "SIROTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "108377",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.150546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.