Andre P Bouhasin, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

2004002409 Issued in MO

Practice address

1151 Hazel LN
Farmington, MO 63640-1920

Phone

(573) 705-7870

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology

Education

Saint Louis University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkland Health Center Hospital, Farmington, MO, CCN 260163
• Parkland Health Center - Bonne Terre Hospital, Bonne Terre, MO, CCN 260779
• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
• Washington County Memorial Hospital Hospital, Potosi, MO, CCN 261308
• Ste Genevieve County Memorial Hospital Hospital, Sainte Genevieve, MO, CCN 261330

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD
• St Louis Specialty Surgical Center LLC

  • Certified Registered Nurse Anesthetist
  • Kirkwood, MO
  • NPI 1962958389
  NPD
• Crystal City Emergency Services, LLC

  • Nurse Practitioner
  • Crystal City, MO
  • NPI 1801844618
  NPD (past)
• Emcare Physician Providers, Inc.

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1386684736
  NPD (past)
• Tracy Riley Counseling LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1306234950
  NPD (past)
• Tracy Riley Counseling LLC

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1902239270
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Care Compare affiliation
• Parkland Health Center

  • General Acute Care Hospital
  • Farmington, MO
  • NPI 1003824061
  Care Compare affiliation
• Parkland Health Center

  • Psychiatric Hospital Unit
  • Farmington, MO
  • NPI 1902814866
  Care Compare affiliation
• Parkland Health Center

  • Rural Acute Care Hospital
  • Bonne Terre, MO
  • NPI 1932117173
  Care Compare affiliation
• Ste Genevieve County Memorial Hospital

  • Critical Access Hospital
  • Ste Genevieve, MO
  • NPI 1073587655
  Care Compare affiliation
• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1508808635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 HAZEL LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401920",
            "telephone_number": "573-701-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 HAZEL LN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401920",
            "telephone_number": "573-705-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUHASIN",
        "first_name": "ANDRE",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2004002409",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2004002409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH",
            "identifier": "947071631",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "426403",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206138802",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "124884",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "513 W Pine St",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636401439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Lynne Borchers, MD
• Makenzie Denae Borchers
• Liliana Borrego
• Maureen Borrego, PA
• Raul A Borrego, MD
• Dena Boyd
• Boyer Counseling and Care LLC
• David Paul Boyer, LPC
• Paula Michelle Boyer, CSS
• Nicole L Boysen, RD

• Interventional Cardiology Physician in Farmington, MO
• Providers in Farmington, MO by specialty
• Interventional Cardiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.

Verify at the official NPI Registry.