Active NPI
Pangaa Fisher, FNP
- Family Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2019015720
- Practice address
- 615 S New Ballas Rd
Saint Louis, MO 63141-8221 - Phone
- (314) 251-6339
- Fax
- (314) 251-4564
- NPI assigned
- Oct 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R0120309 | OK | |
| Family Nurse Practitioner | 363LF0000X | 2019015720 | MO | Primary |
Addresses
Primary practice location
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Mailing address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339
Other names 1
- Pangaa Buniya
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339
Hospital & facility affiliations
- Mercy Hospital St Louis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019015720 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Adult Hospitalists - St. Louis, LLC | Current | Accepting new patients | |
| St. John Physicians, Inc | Current | Accepting new patients | |
| Brookhaven Hospital, LLC | Current | Accepting new patients | |
| St. John Physicians, Inc. | Current | Accepting new patients |
Locations
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660
1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585
201 S Garnett Rd
Tulsa, OK 74128
Phone (918) 438-0083
2000 S Wheeling Ave
Ste 701
Tulsa, OK 74104
Phone (918) 744-7887
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1841235108
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1336194406
-
- Psychiatric Hospital
- Tulsa, OK
- NPI 1023064300
-
- Rural Health Clinic/Center
- Barnsdall, OK
- NPI 1033176367
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1336690288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S NEW BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418221",
"telephone_number": "314-251-6339",
"fax_number": "314-251-4564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S NEW BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418221",
"telephone_number": "314-251-6339",
"fax_number": "314-251-4564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "PANGAA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-16",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "R0120309",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2019015720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PANGAA",
"last_name": "BUNIYA",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}
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 May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.