Individual provider Active NPI

David J. Sewall, M.D.

  • Interventional Cardiology Physician
  • Saint Louis, MO
National Provider Identifier
1336149111
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
R3N49 Issued in MO
Practice address
3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328
Phone
(314) 996-7272
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X R3N49 MO
Interventional Cardiology Physician 207RI0011X R3N49 MO Primary

Addresses

Primary practice location

3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328

Mailing address

3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328
Phone (314) 996-7272

Other identifiers 2

IdentifierTypeStateIssuer
207725805MedicaidMO
207725821MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040422001469 MO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0547162059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Boston University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

3023 N Ballas Rd
Suite 200D
Saint Louis, MO 63131-2328
Phone (314) 996-7272

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3N49MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Jan 17, 2011 Accepting new patients
Physician Groups LC Cardiovascular Disease CurrentSince Jan 17, 2011 Accepting new patients
Mercy Hospital South Past Accepting new patients
Metro Heart Group of St. Louis, Inc. Past Accepting new patients

Locations

1390 US Highway 61
Ste 3300
Crystal Cty, MO 63028
Phone (636) 931-6303

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

3023 N Ballas Rd
Ste 200D
Saint Louis, MO 63131
Phone (314) 996-7272

Interoperability endpoints

  • Direct secure messaging: dsewall11304@direct.carenet.org

Organizations & group practices 4

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 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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1336149111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 200D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312328",
            "telephone_number": "314-996-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 200D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312328",
            "telephone_number": "314-996-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEWALL",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "R3N49",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "R3N49",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207725805",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207725821",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3023 N Ballas Rd",
            "address_2": "Suite 200D",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.