NPIMap

Individual provider Active NPI

Gautam Balakrishnan, MD

  • Pulmonary Disease Physician
  • Saint Joseph, MO
National Provider Identifier
1609214519
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2016023333 Issued in MO
Practice address
5301 Faraon St Ste 210B
Saint Joseph, MO 64506
Phone
(816) 271-1385
Fax
(816) 271-1379
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 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 R9809 IA
Pulmonary Disease Physician 207RP1001X 2016023333 MO Primary

Addresses

Primary practice location

5301 Faraon St Ste 210B
Saint Joseph, MO 64506

Mailing address

5301 Faraon St Ste 210B
Saint Joseph, MO 64506-3512
Phone (816) 271-1385

Other practice location 1

1415 Woodland Ave
Suite 140
Des Moines, IA 50309-3203
Phone (515) 241-5995

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
I20190812002324 MO Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3072749258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heartland Regional Medical Center 394 clinicians

Practice addresses (Care Compare)

5301 Faraon St
Suite 210B
Saint Joseph, MO 64506-3800
Phone (816) 390-8300

Hospital & facility affiliations

  • Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006
  • Mosaic Medical Center Albany Hospital, Albany, MO, CCN 261328
  • Mosaic Medical Center - Maryville Hospital, Maryville, MO, CCN 261340
  • Amberwell Atchison Association Hospital, Atchison, KS, CCN 171382
  • Hiawatha Community Hospital Hospital, Hiawatha, KS, CCN 171341
  • Mosiac Life Care at St Joseph Long-term care hospital, Saint Joseph, MO, CCN 262019

Merit-based Incentive Payment System (MIPS)

Final score
75.47 of 100Reported as group
Quality
81.87
Promoting interoperability
99
Improvement activities
40
Cost
30.23

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R9809IAMDInternal Medicine Physician
2016023333MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Medical Center - Maryville CurrentSince Jun 19, 2025 Accepting new patients
Heartland Regional Medical Center CurrentSince Jul 2, 2019 Accepting new patients
Heartland Regional Medical Center Internal Medicine CurrentSince Jul 2, 2019 Accepting new patients
Mosaic Medical Center - Maryville Internal Medicine CurrentSince Jun 19, 2025 Accepting new patients
Iowa Physicians Clinic Medical Foundation Internal Medicine Past Accepting new patients

Locations

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5301 Faraon St
Ste 210B
Saint Joseph, MO 64506
Phone (816) 271-1385

5301 Faraon St
Ste 210
Saint Joseph, MO 64506
Phone (816) 271-1385

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1609214519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 FARAON ST STE 210B",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063512",
            "telephone_number": "816-271-1385",
            "fax_number": "816-271-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 FARAON ST STE 210B",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-271-1385",
            "fax_number": "816-271-1379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Woodland Ave",
            "address_2": "Suite 140",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503093203",
            "country_code": "US",
            "telephone_number": "515-241-5995",
            "fax_number": "515-241-6576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALAKRISHNAN",
        "first_name": "GAUTAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R9809",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2016023333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.