NPIMap

Individual provider Active NPI

Rama K Gondi, MD

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1396738282
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2003012641 Issued in MO
Practice address
11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6132
Phone
(314) 839-5522
Fax
(314) 839-5351
NPI assigned
Aug 25, 2005
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 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 036109540 IL
Cardiovascular Disease Physician 207RC0000X 2003012641 MO Primary

Addresses

Primary practice location

11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6132

Mailing address

11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6132
Phone (314) 839-5522

Other practice location 1

12255 De Paul Dr Ste 600
Bridgeton, MO 63044-2515
Phone (314) 770-9888

Other identifiers 14

IdentifierTypeStateIssuer
021291OtherFMH
566489OtherHEALTHLINK
P00341379OtherILILRRMCR
8029043OtherCIGNA
7471506OtherAETNA
000000012077OtherESSENCE
195651OtherBLUE CHOICE
021291OtherJFMOLLOY
195651OtherMOMO BC/BS
2299725OtherUHC
H86336OtherMERCY
208998823MedicaidMO
231679OtherGHP
C50434OtherMOMORRMCR

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rgondi22449@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE) Alton Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031219000271 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789582487 Reassigns benefits to 3 organizations
I20050309000225 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789582487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alton Memorial Physician Billing Services LLCGroup PAC ID 9436389442, 11 clinicians
Christian Hospital Physician Billing Services LLCGroup PAC ID 4284796913, 11 clinicians

Practice addresses (Care Compare)

1 Memorial Dr Administration
Alton, IL 62002-6722

11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6188
Phone (314) 839-5522

2 Memorial Dr
Suite 122
Alton, IL 62002-6723
Phone (618) 462-6612

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis Cardiovascular Disease CurrentSince Jan 1, 2016 Accepting new patients
Osf Healthcare System CurrentSince Nov 1, 2014 Accepting new patients
Alton Memorial Physician Billing Services LLC CurrentSince Nov 1, 2019 Accepting new patients
Christian Hospital Physician Billing Services LLC Cardiovascular Disease CurrentSince Nov 1, 2019 Accepting new patients
SSM Medical Group, Inc. Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
Gateway Cardiology PC Cardiovascular Disease PastSince Jul 15, 1994 Accepting new patients
John P Marino MD LLC Past Accepting new patients
Alton Memorial Physician Billing Services, LLC Past Accepting new patients
St Louis Cardiology Consultants LTD Cardiovascular Disease Past Accepting new patients
Saint Anthonys Health Center Past Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2 Memorial Dr
Ste 102
Alton, IL 62002
Phone (618) 288-0900

2 Memorial Dr
Ste 122
Alton, IL 62002
Phone (618) 462-6612

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

12255 De Paul Dr
Ste 600
Bridgeton, MO 63044
Phone (314) 209-5100

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

300 Medical Plz
Ste 221
Lake St Louis, MO 63367
Phone (636) 561-2229

2963 Doddridge Ave
Maryland Hts, MO 63043
Phone (314) 291-3909

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

11125 Dunn Rd
Ste 204
Saint Louis, MO 63136
Phone (314) 355-2300

11133 Dunn Rd
Ste 2346
Saint Louis, MO 63136
Phone (314) 653-5125

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: rgondi135712@direct.carenet.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1396738282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "address_2": "SUITE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-839-5522",
            "fax_number": "314-839-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "address_2": "SUITE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-839-5522",
            "fax_number": "314-839-5351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12255 De Paul Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442515",
            "country_code": "US",
            "telephone_number": "314-770-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONDI",
        "first_name": "RAMA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036109540",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2003012641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FMH",
            "identifier": "021291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "566489",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILRRMCR",
            "identifier": "P00341379",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8029043",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7471506",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000012077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "195651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JFMOLLOY",
            "identifier": "021291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BC/BS",
            "identifier": "195651",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2299725",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "H86336",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208998823",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "231679",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MORRMCR",
            "identifier": "C50434",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgondi22449@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rgondi22449@direct-ehr-ssmhc.com",
            "address_1": "12255 De Paul Dr Ste 600",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "12255 De Paul Dr Ste 600",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "Y",
            "affiliationName": "Alton Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Memorial Dr",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026722",
            "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.