Individual provider Active NPI

Vijay K Patnana, M.D.

  • Anesthesiology Physician
  • Chesterfield, MO
National Provider Identifier
1366448722
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2001019664 Issued in MO
Practice address
17050 Baxter Rd
Suite #110
Chesterfield, MO 63005-1422
Phone
(636) 200-4242
Fax
(636) 200-4243
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2001019664 MO Primary

Addresses

Primary practice location

17050 Baxter Rd
Suite #110
Chesterfield, MO 63005-1422

Mailing address

351 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 200-4242

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
I20070222000464 MO Practitioner - Anesthesiology 6002918042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Anesthesiology Associates IncGroup PAC ID 6204720667, 251 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-4687

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Anesthesiology Associates, Inc. Anesthesiology CurrentSince Jan 1, 2002 Accepting new patients
Robert H and Teresita S Petty Anesthesiology Past Accepting new patients

Locations

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

17050 Baxter Rd
Ste 110
Chesterfield, MO 63005
Phone (636) 537-0122

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

5401 Veterans Memorial Pkwy
Ste 100
Saint Peters, MO 63376
Phone (636) 441-0906

901 Patients First Dr
Ste 108
Washington, MO 63090
Phone (636) 390-1715

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 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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1366448722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-200-4242",
            "fax_number": "636-200-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17050 BAXTER RD",
            "address_2": "SUITE #110",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051422",
            "telephone_number": "636-200-4242",
            "fax_number": "636-200-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATNANA",
        "first_name": "VIJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2001019664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.