NPIMap

Individual provider Active NPI

Randa Sawaf-Hajji, MD

  • Internal Medicine Physician
  • Bridgeton, MO
National Provider Identifier
1437363553
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2004033970 Issued in MO
Practice address
12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2510
Phone
(314) 209-5100
Fax
(314) 209-5152
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2004033970 MO Primary

Addresses

Primary practice location

12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2510

Mailing address

12255 De Paul Dr
Suite 600
Bridgeton, MO 63044-2510
Phone (314) 209-5100

Other names 1

  • Randa Sawaf Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070706000134 MO Practitioner - Internal Medicine 3678673555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinic of Internal Medicine LLCGroup PAC ID 6305870361, 6 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

121 Saint Lukes Ctr Dr
Chesterfield, MO 63017-3519
Phone (314) 576-8102

15425 Manchester Rd
Suite 28
Ballwin, MO 63011-3077
Phone (636) 220-6969

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004033970MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic of Internal Medicine, LLC Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
Cardiothoracic Surgery, LLC PastSince Jan 1, 2019 Accepting new patients

Locations

121 Saint Lukes Center Dr
Ste 506
Chesterfield, MO 63017
Phone (314) 576-8102

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.

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1437363553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "SUITE 600",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-209-5100",
            "fax_number": "314-209-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "SUITE 600",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-209-5100",
            "fax_number": "314-209-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWAF-HAJJI",
        "first_name": "RANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2004033970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDA",
            "last_name": "SAWAF",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.