Individual provider Active NPI

Issam Atallah, MD

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1487147971
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2021013982 Issued in MO
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250716001215 MO Practitioner - Interventional Cardiology 3971903972 Reassigns benefits to 2 organizations

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
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

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

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018012088MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis Cardiovascular Disease CurrentSince Oct 18, 2025 Accepting new patients
SSM Health Care St. Louis Internal Medicine CurrentSince Oct 18, 2025 Accepting new patients
SSM Medical Group Inc. CurrentSince May 11, 2025 Accepting new patients
SSM Medical Group, Inc. Internal Medicine CurrentSince May 11, 2025 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.