Individual provider Active NPI

Muhammad Ehtisham, M.D.

  • Pulmonary Disease Physician
  • Cape Girardeau, MO
National Provider Identifier
1407222433
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2021030438 Issued in MO
Practice address
371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone
(573) 331-7830
NPI assigned
Aug 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 2021030438 MO Primary

Addresses

Primary practice location

371 S Broadview St
Cape Girardeau, MO 63703-5761

Mailing address

PO Box 776084
Chicago, IL 60677-6084

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
I20211104002539 MO Practitioner - Pulmonary Disease 3779890629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1019 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-7702

371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone (573) 331-6710

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Delta Medical Center CurrentSince Oct 4, 2021 Accepting new patients
Missouri Delta Medical Center Internal Medicine CurrentSince Oct 4, 2021 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Pulmonary Disease CurrentSince Mar 20, 2025 Accepting new patients

Locations

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

1019 N Main St
Sikeston, MO 63801
Phone (573) 472-7702

Organizations & group practices 3

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 5

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": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1407222433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035761",
            "telephone_number": "573-331-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHTISHAM",
        "first_name": "MUHAMMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-13",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2021030438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.