Active NPI
Usha Rani Muthyala, M.D.
- Hospitalist Physician
- Belleville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 036138373
- Practice address
- 211 S 3Rd St
Belleville, IL 62220-1915 - Phone
- (618) 234-2120
- Fax
- (618) 641-5806
- NPI assigned
- Jul 31, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2010019780 | MO | |
| Hospitalist Physician | 208M00000X | 2010019780 | MO | |
| Hospitalist Physician | 208M00000X | 036138373 | IL | Primary |
Addresses
Primary practice location
211 S 3Rd St
Belleville, IL 62220-1915
Mailing address
211 S 3Rd St
Belleville, IL 62220-1915
Phone (618) 234-2120
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396935888 | Medicaid | MO | |
| 1396925888 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000
6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone (314) 768-8000
Hospital & facility affiliations
- SSM Health Depaul Hospital St Louis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036138373 | IL | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Physicians of Illinois, LLC | Internal Medicine | Current | Accepting new patients |
| Cogent Healthcare of Missouri, Inc | Current | Accepting new patients | |
| Eagle Crest Counseling Center, Inc. | Past | Accepting new patients | |
| SSM Health Care St. Louis | Past | Accepting new patients | |
| McGuire Christian Counseling Inc. | Past | Accepting new patients |
Locations
12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674
Organizations & group practices 5
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.
-
- Hospitalist Physician
- Bridgeton, MO
- NPI 1043598865
Internal Medicine
-
- Critical Care Medicine (Internal Medicine) Physician
- Fenton, MO
- NPI 1780961599
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Springfield, MO
- NPI 1659421931
-
- Community/Behavioral Health Agency
- Springfield, MO
- NPI 1912141789
-
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1396935888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201915",
"telephone_number": "618-234-2120",
"fax_number": "618-641-5806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201915",
"telephone_number": "618-234-2120",
"fax_number": "618-641-5806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTHYALA",
"first_name": "USHA",
"middle_name": "RANI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-31",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2010019780",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MO",
"license": "2010019780",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036138373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396935888",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396925888",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.