Active NPI
Issam Atallah, MD
- Cardiovascular Disease Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 2021013982
- Practice address
- 1008 S Spring Ave Ste 2100
Saint Louis, MO 63110-2520 - Phone
- (702) 277-9607
- NPI assigned
- Jun 11, 2018
- Last updated
- Aug 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2018012088 | MO | |
| Cardiovascular Disease Physician | 207RC0000X | 2021013982 | MO | Primary |
Addresses
Primary practice location
1008 S Spring Ave Ste 2100
Saint Louis, MO 63110-2520
Mailing address
1008 S Spring Ave Ste 2100
Saint Louis, MO 63110-2520
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1027 Bellevue Ave
Suite 200
Saint Louis, MO 63117-1851
Phone (314) 645-6450
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018012088 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St Louis | Cardiovascular Disease | Current | Accepting new patients |
| SSM Health Care St. Louis | Internal Medicine | Current | Accepting new patients |
| SSM Medical Group Inc. | Current | Accepting new patients | |
| SSM Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| SSM Depaul Medical Group, Inc. | Internal Medicine | Past | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1027 Bellevue Ave
Ste 200
Saint Louis, MO 63117
Phone (314) 644-3336
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
Interoperability endpoints
- iatallah396523@direct-ehr-ssmhc.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SSM Health St Clare Fenton
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
Cardiovascular Disease
-
dba SSM Health Medical Group
- Multi-Specialty Clinic/Center
- Fenton, MO
- NPI 1700966207
Internal Medicine
-
dba SSM Health St. Mary's Hospital Physician Billing
- Emergency Medicine Physician
- Saint Louis, MO
- NPI 1366400855
Internal Medicine
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Warrenton, MO
- NPI 1467997155
-
dba SSM Health Medical Group
- Internal Medicine Physician
- Maryland Heights, MO
- NPI 1760456743
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health Cardinal Glennon Children's Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
dba SSM Health St. Mary's Hospital - St. Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
-
dba SSM Health Saint Louis University Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1487147971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 S SPRING AVE STE 2100",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 S SPRING AVE STE 2100",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102520",
"telephone_number": "702-277-9607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATALLAH",
"first_name": "ISSAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2021-08-20",
"certification_date": "2021-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2018012088",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MO",
"license": "2021013982",
"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 Aug 20, 2021; 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.