Individual provider Active NPI

Nida Jamal, M.D.

  • Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1457701104
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2020008146 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6339
Fax
(314) 251-4564
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X 2020008146 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339

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
I20210915000667 MO Practitioner - Neurology 1355637117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians
Mercy Clinic Adult Hospitalists - St. Louis, LLCGroup PAC ID 6002809944, 139 clinicians

Practice addresses (Care Compare)

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6075

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC CurrentSince Aug 20, 2021 Accepting new patients
Mercy Aco Clinical Services Inc Neurology CurrentSince Sep 5, 2021 Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

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.

Hospital & facility affiliations 2

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1457701104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6339",
            "fax_number": "314-251-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6339",
            "fax_number": "314-251-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMAL",
        "first_name": "NIDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2020008146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.