Karl Taira, MD
Individual provider Active NPI Family Medicine Physician · Saint Louis, MO
NPI 1457582082 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1457582082
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2011009299 (MO)
- Practice address
- 969 N Mason Rd Ste 145a
Saint Louis, MO 63141-6282 - Phone
- (314) 996-3432
- NPI assigned
- Jul 30, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Southern Illinois University School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Physician Groups LC
Practice addresses (Care Compare)
969 N Mason Rd
Suite 145
Saint Louis, MO 63141-6338
Phone (314) 996-3432
Hospital & facility affiliations
- Elara Caring
- Barnes-Jewish West County Hospital
- Missouri Baptist Medical Center
- Barnes Jewish Hospital
- SSM Health Rehabilitation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110504000313 | MO | Practitioner - Family Practice | 5294881033 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011009299 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Current |
Accepting new patients | |
| Physician Groups LC | Family Medicine | Current |
Accepting new patients |
| Fairview Heights Medical Group SC | Past |
Accepting new patients | |
| Southern Illinois Medical Care Associates LLC | Family Medicine | Past | Accepting new patients |
| SSM Depaul Medical Group, Inc. | Family Medicine | Past | Accepting new patients |
Locations
2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454
969 N Mason Rd
Ste 145A
Saint Louis, MO 63141
Phone (314) 996-3432
969 N Mason Rd
Ste 145
Saint Louis, MO 63141
Phone (314) 878-6008
Interoperability endpoints
- ktaira34679@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2011009299 | MO | Yes |
Addresses
Primary practice location
969 N Mason Rd Ste 145a
Saint Louis, MO 63141-6282
Mailing address
969 N Mason Rd Ste 145a
Saint Louis, MO 63141-6282
Phone (314) 996-3432
Other practice location 1
14021 New Halls Ferry Rd
Florissant, MO 63033-2708
Phone (314) 839-0910
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | ktaira34679@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in Saint Louis, MO
- Fahad Bin Tahir
- Mohammad Tahir
- Fariba Tahmasebi-Moshiri
- Neda Tahmasebi
- Chandrakant C Tailor
- Raymond C Tait
- Tsuyoshi Takahashi
- Daiji Takajo
- Take Care Health Missouri, PC
- Take Care in Home Service, LLC
All providers in Saint Louis, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.