Active NPI
Ameesh Dara, D.O.
- Nephrology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 2019015695
- Practice address
- 777 S New Ballas Rd Ste 328W
Saint Louis, MO 63141-8748 - Phone
- (314) 869-0370
- Fax
- (314) 869-5098
- NPI assigned
- May 1, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 036.148828 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Nephrology Physician | 207RN0300X | 2019015695 | MO | Primary |
Addresses
Primary practice location
777 S New Ballas Rd Ste 328W
Saint Louis, MO 63141-8748
Mailing address
1234 Lay Rd
Saint Louis, MO 63124-1872
Phone (314) 456-6659
Other practice location 1
4100 Union Blvd Unit B
Saint Louis, MO 63115-1225
Phone (314) 531-1112
Other practice location 2
4100 Union Blvd Unit B1
Saint Louis, MO 63115-1225
Phone (314) 869-0370
Other practice location 3
1224 Graham Rd Ste 1111
Florissant, MO 63031-8028
Phone (314) 869-0370
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190924003212 | MO | Practitioner - Nephrology | 7618279159 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Kansas City University of Physicians and Surgeons, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Metro St Louis Renal Services Inc
Practice addresses (Care Compare)
4100 Union Blvd
Saint Louis, MO 63115-1225
Phone (314) 869-0370
Hospital & facility affiliations
- FMC - Bridgeton
- Gateway St Louis Dialysis, LLC
- DaVita Bowles Avenue Dialysis
- Mercy Hospital St Louis
- SSM Health Depaul Hospital St Louis
- Select Specialty Hospital-St Louis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.148828 | IL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Medical Associates, LLC | Nephrology | Current | Accepting new patients |
Locations
1224 Graham Rd
Ste 1111
Florissant, MO 63031
Phone (314) 837-3720
4100 Union Blvd
#B
Saint Louis, MO 63115
Phone (314) 531-1112
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1275705501
MO, Nephrology
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Saint Louis, MO
- NPI 1497074520
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Fenton, MO
- NPI 1154617892
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Bridgeton, MO
- NPI 1275645178
Dialysis facility
-
- Long Term Care Hospital
- Saint Charles, MO
- NPI 1275533747
Long-term care hospital
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647648000000",
"number": "1417367244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1234 LAY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631241872",
"telephone_number": "314-456-6659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 S NEW BALLAS RD STE 328W",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418748",
"telephone_number": "314-869-0370",
"fax_number": "314-869-5098"
}
],
"practiceLocations": [
{
"address_1": "4100 Union Blvd Unit B",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631151225",
"country_code": "US",
"telephone_number": "314-531-1112",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4100 Union Blvd Unit B1",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631151225",
"country_code": "US",
"telephone_number": "314-869-0370",
"fax_number": "314-869-5098",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1224 Graham Rd Ste 1111",
"address_purpose": "LOCATION",
"city": "Florissant",
"state": "MO",
"postal_code": "630318028",
"country_code": "US",
"telephone_number": "314-869-0370",
"fax_number": "314-869-5098",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DARA",
"first_name": "AMEESH",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-01",
"last_updated": "2022-03-19",
"certification_date": "2022-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IL",
"license": "036.148828",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MO",
"license": "2019015695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Mar 19, 2022; 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.