Active NPI
Kulsoom Fatima Junaid, M.D.
- Psychiatry Physician
- Saint Louis, MO
National Provider Identifier
1497827968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2001017151
- Practice address
- 1400 Lemay Ferry Rd
Saint Louis, MO 63125-2408 - Phone
- (314) 776-7990
- Fax
- (314) 772-2257
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2001017151 | MO | Primary |
Addresses
Primary practice location
1400 Lemay Ferry Rd
Saint Louis, MO 63125-2408
Mailing address
11 Summerhill LN
Town and Country, MO 63017-8408
Phone (314) 922-2662
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205741903 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Oakland College of Medicine and Surgery, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1400 Lemay Ferry Rd
Saint Louis, MO 63125-2408
Phone (314) 776-7990
777 Craig Rd
Suite 200
Creve Coeur, MO 63141-7190
Phone (314) 549-8494
Hospital & facility affiliations
- Gateway Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001017151 | MO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breeze Hospice of Missouri, LLC | Current | Accepting new patients | |
| St Louis Behavioral Health Associates, LLC | Psychiatry | Current | Accepting new patients |
| American Healthcare Systems Illinois LLC | Past | Accepting new patients | |
| Breeze Hospice, LLC | Past | Accepting new patients | |
| American Healthcare Systems Illinois LLC | Past | Accepting new patients |
Locations
3535 S Jefferson Ave
Ste 118
Saint Louis, MO 63118
Phone (314) 773-1822
1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955
Interoperability endpoints
- kjunaid14687@direct-ehr-ssmhc.com
- jkulsoom@yourcarecommunity.org
Organizations & group practices 6
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.
-
- Psychiatry Physician
- Saint Louis, MO
- NPI 1780749457
-
- Community Based Hospice Care Agency
- Saint Louis, MO
- NPI 1538537816
-
- Community Based Hospice Care Agency
- Swansea, IL
- NPI 1669898805
-
- Psychiatric Hospital Unit
- Granite City, IL
- NPI 1043918576
-
- General Acute Care Hospital
- Granite City, IL
- NPI 1326765884
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Granite City, IL
- NPI 1326765884
-
- Urgent Care Clinic/Center
- Glen Carbon, IL
- NPI 1700586344
Hospital
-
- Urgent Care Clinic/Center
- Columbia, IL
- NPI 1982304523
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1497827968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SUMMERHILL LN",
"city": "TOWN AND COUNTRY",
"state": "MO",
"postal_code": "630178408",
"telephone_number": "314-922-2662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 LEMAY FERRY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631252408",
"telephone_number": "314-776-7990",
"fax_number": "314-772-2257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNAID",
"first_name": "KULSOOM",
"middle_name": "FATIMA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2001017151",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205741903",
"state": "MO"
}
],
"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 May 17, 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.