Individual provider Active NPI

Humza Omar Quadri, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1457912255
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019022856 Issued in MO
Practice address
3009 N Ballas Rd Ste 100B
Saint Louis, MO 63131-2322
Phone
(314) 432-1111
Fax
(314) 432-3629
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2019022856 MO Primary

Addresses

Primary practice location

3009 N Ballas Rd Ste 100B
Saint Louis, MO 63131-2322

Mailing address

551 E Southampton Dr
Columbia, MO 65201-4236
Phone (573) 884-7733

Other practice location 1

1400 LeMay Ferry Rd
Saint Louis, MO 63125-2408
Phone (314) 432-1111

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
I20221118001556 MO Practitioner - Family Practice 3779818901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Medical Clinic, P.C.Group PAC ID 2961496765, 11 clinicians

Practice addresses (Care Compare)

3009 N Ballas Rd
Saint Louis, MO 63131-2322
Phone (314) 432-1111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Medical Clinic, P.C. Family Medicine CurrentSince Nov 21, 2022 Accepting new patients

Locations

1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955

3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131
Phone (314) 270-1796

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDDCDD

Organizations & group practices 1

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 7

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1457912255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 E SOUTHAMPTON DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014236",
            "telephone_number": "573-884-7733",
            "fax_number": "573-882-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 100B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-432-1111",
            "fax_number": "314-432-3629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 LeMay Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631252408",
            "country_code": "US",
            "telephone_number": "314-432-1111",
            "fax_number": "314-432-3629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUADRI",
        "first_name": "HUMZA",
        "middle_name": "OMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019022856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.