Suraj Kumar Alakkassery Kumaran, MD
Individual provider Active NPI Internal Medicine Physician · Washington, MO
NPI 1568698306 · NPPES record last updated Feb 6, 2023
Key facts
- NPI
- 1568698306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2012013456 (MO)
- Practice address
- 901 E 5TH St
Washington, MO 63090-3127 - Phone
- (636) 239-8231
- NPI assigned
- Jun 8, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Palliative Care LLC
Practice addresses (Care Compare)
621 S New Ballas Rd
6017B Mercy Clinic Palliative Care Medi
Saint Louis, MO 63141-8274
Phone (314) 251-7840
Hospital & facility affiliations
- Mercy Hospital St Louis
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120926000398 | MO | Practitioner - Internal Medicine |
0244489821 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital Lincoln | Internal Medicine | Current |
Accepting new patients |
| St Anthonys Physician Organization Hospitalist Services, L.C. | Current |
Accepting new patients | |
| Mercy Clinic Palliative Care, LLC | Current |
Accepting new patients | |
| Mercy Clinic Adult Hospitalists - Washington, LLC | Current |
Accepting new patients | |
| Mercy Clinic Adult Hospitalists- Jefferson, LLC | Internal Medicine | Current |
Accepting new patients |
| Compass Health, Inc. | Past | Accepting new patients | |
| Mercy Hospitals East Communities | Internal Medicine | Past | Accepting new patients |
Locations
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
621 S New Ballas Rd
Ste 6017B
Saint Louis, MO 63141
Phone (314) 251-4652
615 S New Ballas Rd
#C
Saint Louis, MO 63141
Phone (314) 569-6000
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585
901 E 5th St
Washington, MO 63090
Phone (636) 239-8000
Interoperability endpoints
- salakkasserykumaran999930@directc.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2012013456 | MO | Yes |
Addresses
Primary practice location
901 E 5TH St
Washington, MO 63090-3127
Mailing address
901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8231
Other practice location 1
621 S New Ballas Rd Ste 6017B
Saint Louis, MO 63141-8274
Phone (314) 251-7840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568698306 | Medicaid | MO |
Other providers in Washington, MO
- A Peaceful Heart LLC
- Advanced Hearing Care
- Advanced Sight Center, Inc.
- Elizabeth Aholt
- Hannah Alfermann
- Jerry H Allen
- Mamdouh Alrata
- Karen Altemueller
- Americare at Victorian Manor of Washington
All providers in Washington, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.