Organization Active NPI

Ehab M Kaiser, MD, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1306922141
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000157953 Issued in MO
Legal business name
EHAB M KAISER, MD, LLC
Practice address
2 McKnight PL
Saint Louis, MO 63124-1900
Phone
(314) 434-1600
Fax
(314) 463-4466
NPI assigned
Oct 27, 2006
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Dr. Ehab Kaiser, MDNPI 1205804796
Title
President
Phone
(314) 780-4785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 2000157953 MO Primary

Addresses

Primary practice location

2 McKnight PL
Saint Louis, MO 63124-1900

Mailing address

PO Box 410121
Saint Louis, MO 63141-0121
Phone (314) 578-0478

Other identifiers 1

IdentifierTypeStateIssuer
500505706MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehabkaisermd@direct.practicefusion.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060207000267 MO Part B Supplier - Clinic/Group Practice 0042225468 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

1035 Bellevue Ave
Ste 316
Saint Louis, MO 63117
Phone (314) 647-8282

331 N New Ballas Rd
Unit 410121
Saint Louis, MO 63141

522 N New Ballas Rd
Ste 199
Saint Louis, MO 63141
Phone (314) 432-2323

Interoperability endpoints

  • Direct secure messaging: ehabkaisermd@direct.practicefusion.com

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1306922141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410121",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631410121",
            "telephone_number": "314-578-0478",
            "fax_number": "314-463-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MCKNIGHT PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241900",
            "telephone_number": "314-434-1600",
            "fax_number": "314-463-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EHAB M KAISER, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "KAISER",
        "authorized_official_first_name": "EHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-780-4785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2000157953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500505706",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehabkaisermd@direct.practicefusion.com",
            "affiliation": "N",
            "address_1": "1035 Bellevue Ave Ste 316",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631171845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.