NPIMap

Individual provider Active NPI

Daniel Gaitan, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1598865636
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
103118 Issued in MO
Practice address
425 N New Ballas Rd Ste 107
Saint Louis, MO 63141-6845
Phone
(314) 432-2592
Fax
(314) 432-2595
NPI assigned
Sep 25, 2006
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 103118 MO
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD103118 MO
Internal Medicine Physician 207R00000X 103118 MO Primary

Addresses

Primary practice location

425 N New Ballas Rd Ste 107
Saint Louis, MO 63141-6845

Mailing address

425 N New Ballas Rd Ste 107
Saint Louis, MO 63141-6845
Phone (314) 432-2592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000950 MO Practitioner - Internal MedicinePractitioner - Endocrinology 7416084819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
University of Mississippi School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 N New Ballas Rd
Suite 107
Saint Louis, MO 63141-6845
Phone (314) 432-2592

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103118MOMDEndocrinology, Diabetes & Metabolism Physician
MD103118MOMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Gaitan Healthcare, Inc Endocrinology, Diabetes & Metabolism CurrentSince Mar 2, 2020 Accepting new patients

Locations

425 N New Ballas Rd
Ste 107
Saint Louis, MO 63141
Phone (314) 432-2592

Organizations & group practices 1

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 8

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1598865636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416845",
            "telephone_number": "314-432-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416845",
            "telephone_number": "314-432-2592",
            "fax_number": "314-432-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAITAN",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "103118",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "MD103118",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "103118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.