Individual provider Active NPI

Amana N Nasir, M.D.

  • Pediatric Gastroenterology Physician
  • Saint Louis, MO
National Provider Identifier
1306050273
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
2010037942 Issued in MO
Practice address
615 S New Ballas Rd
Children's Hospital, Ground Floor, Suite Y-G224
Saint Louis, MO 63141-8221
Phone
(314) 251-5550
Fax
(314) 251-5552
NPI assigned
May 10, 2007
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 2010037942 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Children's Hospital, Ground Floor, Suite Y-G224
Saint Louis, MO 63141-8221

Mailing address

615 S New Ballas Rd Ste Y-G230
Saint Louis, MO 63141-8221
Phone (314) 251-5550

Other practice location 1

4525 Mid Rivers Mall Dr Ste 10
Cottleville, MO 63376-2820
Phone (314) 251-5550

Other identifiers 1

IdentifierTypeStateIssuer
3810008920MedicaidWV

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
I20160531001912 MO Practitioner - Pediatric Medicine 6103924030 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Kids Gi, LLC Pediatric Gastroenterology CurrentSince Apr 26, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

615 S New Ballas Rd
Ste YG224
Saint Louis, MO 63141
Phone (314) 251-5550

615 S New Ballas Rd
Ste YG230
Saint Louis, MO 63141
Phone (314) 251-5399

4525 Mid Rivers Mall Dr
Ste 10
Saint Peters, MO 63376
Phone (314) 251-5550

Interoperability endpoints

  • Direct secure messaging: anasir194060@directc.mercy.net

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1306050273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD STE Y-G230",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-5550",
            "fax_number": "314-251-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "CHILDREN'S HOSPITAL, GROUND FLOOR, SUITE Y-G224",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-5550",
            "fax_number": "314-251-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Mid Rivers Mall Dr Ste 10",
            "address_purpose": "LOCATION",
            "city": "Cottleville",
            "state": "MO",
            "postal_code": "633762820",
            "country_code": "US",
            "telephone_number": "314-251-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASIR",
        "first_name": "AMANA",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MO",
            "license": "2010037942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810008920",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.