Alexander K Mammen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36849 Issued in MO

Practice address

4530 Lemay Ferry Rd
Suite M
Saint Louis, MO 63129-1600

Phone

(314) 487-8724

Fax

(314) 487-0443

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Family Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Missouri Home health agency, Hillsboro, MO, CCN 267270
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Infectious Disease

  • Infectious Disease Physician
  • Saint Louis, MO
  • NPI 1225494628
  NPD (past)

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

• Amedisys Missouri, L.L.C.

  • Home Health Agency
  • Hillsboro, MO
  • NPI 1164433041
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1609874734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 LEMAY FERRY RD",
            "address_2": "SUITE M",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291600",
            "telephone_number": "314-487-8724",
            "fax_number": "314-487-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 LEMAY FERRY RD",
            "address_2": "SUITE M",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291600",
            "telephone_number": "314-487-8724",
            "fax_number": "314-487-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMEN",
        "first_name": "ALEXANDER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Erin Malzahn
• Daniel Tonye Mamah, MD
• Tatiana Mamaliga, MD
• Anila Mamidi, MD
• Maria G Maminta Streiff, M.D.
• Sarah U Mammen, D.D.S.
• Asma Mammootty, MD
• Niyaza Mammootty, MD
• Tornike Mamuladze
• Michelle Man

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.