Individual provider Active NPI

Kenan Sahbaz, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1285143545
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017023107 Issued in MO
Practice address
3009 N Ballas Rd Ste 351C
Saint Louis, MO 63131-2324
Phone
(314) 996-4790
Fax
(314) 996-4792
NPI assigned
Sep 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017023107 MO Primary

Addresses

Primary practice location

3009 N Ballas Rd Ste 351C
Saint Louis, MO 63131-2324

Mailing address

670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573
Phone (314) 996-4790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200421000145 IL Practitioner - Nurse Practitioner 4486910114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Sinus Sleep and Allergy Associates, LLCGroup PAC ID 1850705096, 13 clinicians

Practice addresses (Care Compare)

1179 Fortune Blvd
Shiloh, IL 62269-7377
Phone (618) 628-0715

4224 Lincolnshire Dr
Suite B
Mount Vernon, IL 62864-2156
Phone (618) 816-7722

Hospital & facility affiliations

  • Anderson Hospital Hospital, Maryville, IL, CCN 140289
  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348
  • St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
  • SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Merit-based Incentive Payment System (MIPS)

Final score
75.22 of 100Reported as group
Quality
63.94
Promoting interoperability
80
Improvement activities
40
Cost
70.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Sinus Sleep & Allergy Associates, LLC CurrentSince Jul 29, 2022 Accepting new patients
ENT & Sleep Medicine Associates LLC Past Accepting new patients
Granite City Physicians Corp Past Accepting new patients

Locations

4224 Lincolnshire Dr
#B
Mount Vernon, IL 62864
Phone (618) 242-0101

1179 Fortune Blvd
Shiloh, IL 62269
Phone (309) 368-8984

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBIIBD
  • Direct secure messaging: ksahbaz@yourcarecommunity.org

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 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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1285143545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-996-4790",
            "fax_number": "314-996-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 351C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-4790",
            "fax_number": "314-996-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHBAZ",
        "first_name": "KENAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017023107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.