Individual provider Active NPI

Soumya M Nadella, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Chesterfield, MO
National Provider Identifier
1316350028
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2019033228 Issued in MO
Practice address
224 S Woods Mill Rd Ste 480S
Chesterfield, MO 63017-3609
Phone
(366) 857-7446
Fax
(314) 590-5957
NPI assigned
Jun 10, 2014
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014016507 MO
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2019033228 MO Primary

Addresses

Primary practice location

224 S Woods Mill Rd Ste 480S
Chesterfield, MO 63017-3609

Mailing address

2186 Englewood Ter
Chesterfield, MO 63017-7281

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
I20190924000683 MO Practitioner - Endocrinology 3173826492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endocrine Associates, LLCGroup PAC ID 3779865381, 4 clinicians

Practice addresses (Care Compare)

224 S Woods Mill Rd
Suite 480S
Chesterfield, MO 63017-3609
Phone (636) 685-7744

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019033228MOMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Associates, LLC Endocrinology, Diabetes & Metabolism CurrentSince Sep 9, 2019 Accepting new patients
St. Lukes Medical Group Internal Medicine Past Accepting new patients

Locations

224 S Woods Mill Rd
Ste 480S
Chesterfield, MO 63017
Phone (314) 542-0700

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.

Hospital & facility affiliations 1

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1316350028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 ENGLEWOOD TER",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD STE 480S",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173609",
            "telephone_number": "366-857-7446",
            "fax_number": "314-590-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADELLA",
        "first_name": "SOUMYA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014016507",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2019033228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.