Individual provider Active NPI

Imran Haider, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1306132196
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2014021221 Issued in MO
Practice address
10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106
Phone
(314) 525-1328
Fax
(314) 525-1378
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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 9003635-1205 UT
Cardiovascular Disease Physician 207RC0000X BP10054986 TX
Internal Medicine Physician 207R00000X 2014021221 MO Primary

Addresses

Primary practice location

10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106

Mailing address

10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106
Phone (314) 525-1328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, 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
I20150328000217 UT Practitioner - Internal Medicine 4688813439 Reassigns benefits to 1 organization
I20160524000737 MO Practitioner - HospitalistPractitioner - Internal Medicine 4688813439 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Specialists of St Lukes LLCGroup PAC ID 1557366960, 77 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1899

10018 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-3423

232 S Woods Mill Rd
Chesterfield, MO 63017-3406
Phone (314) 434-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10054986TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Regional Hospitalists LLC CurrentSince Feb 9, 2015 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Cardiovascular Disease CurrentSince Jun 6, 2016 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Feb 9, 2015 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Dec 1, 2021 Accepting new patients
Physician Specialists of St Lukes LLC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Jul 1, 2016 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Jul 1, 2016 Accepting new patients
Galen Inpatient Physicians PC. Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
St. Lukes Episcopal-Presbyterian Hospital Past Accepting new patients
Mercy Hospital South Past Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC Internal Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

121 Saint Lukes Center Dr
Chesterfield, MO 63017
Phone (314) 434-3278

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

10010 Kennerly Rd
#3
Saint Louis, MO 63128
Phone (314) 525-1328

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 14

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.

View all 14

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1306132196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "address_2": "3 SOUTHBRIDGE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "address_2": "3 SOUTHBRIDGE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1328",
            "fax_number": "314-525-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDER",
        "first_name": "IMRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "9003635-1205",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "BP10054986",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014021221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.