Tanvira K Alam, DO
Individual provider Active NPI Obstetrics & Gynecology Physician · O Fallon, MO
NPI 1265670525 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1265670525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 2012028275 (MO)
- Practice address
- 1101 Highway K
O Fallon, MO 63366-8431 - Phone
- (636) 379-6363
- NPI assigned
- Jan 25, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SSM Medical Group Inc
Practice addresses (Care Compare)
1101 Hwy K
O Fallon, MO 63366-8431
Phone (636) 379-6363
Hospital & facility affiliations
- SSM St Joseph Hospital West
- SSM St Joseph Health Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121015000718 | MO | Practitioner - Obstetrics/Gynecology | 7911157656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group, Inc. | Current |
Accepting new patients | |
| SSM Health Care St. Louis | Past | Accepting new patients | |
| SSM Health Care St. Louis | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
300 Medical Plz
Ste 310
Lake St Louis, MO 63367
Phone (314) 291-6556
1101 Highway K
O Fallon, MO 63366
Phone (636) 379-6347
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
Interoperability endpoints
- talam190247@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 2012028275 | MO | Yes |
Addresses
Primary practice location
1101 Highway K
O Fallon, MO 63366-8431
Mailing address
PO Box 955534
Saint Louis, MO 63195-5534
Other practice location 1
1050 W 10th St
Ste 510
Rolla, MO 65401
Phone (573) 426-2229
Other names
- Tanvira Alam
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | talam190247@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in O Fallon, MO
- Air Evac EMS, Inc.
- Air Evac EMS, Inc.
- Ak Home Health Care, LLC
- Shonna Renee Akinbobola
- Jacquelyn Ani Akmakjian
- Albers Chiropractic Health Center, PC
- Susan D Albers
- All About Health Chiropractic, LLC
- Jeffrey Lee Allen
- Gregory Scott Alles
All providers in O Fallon, MO · Obstetrics & Gynecology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.