Individual provider Active NPI

Vafa Foroughi, MD

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1619968336
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
100645 Issued in MO
Practice address
760 Office Pkwy
Saint Louis, MO 63141-7105
Phone
(314) 200-1462
Fax
(314) 942-1613
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 100645 MO Primary

Addresses

Primary practice location

760 Office Pkwy
Saint Louis, MO 63141-7105

Mailing address

760 Office Pkwy
Saint Louis, MO 63141-7105
Phone (314) 200-1462

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040820000303 MO Practitioner - Anesthesiology 6204800824 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100645MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia LLC Anesthesiology CurrentSince Feb 16, 2006 Accepting new patients

Locations

14825 North Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 898-4695

10 S Hospital Dr
Fulton, MO 65251
Phone (573) 592-6550

760 Office Pkwy
Saint Louis, MO 63141
Phone (314) 328-7648

760 Office Pkwy
Ste 100
Saint Louis, MO 63141
Phone (314) 200-1462

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1619968336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 OFFICE PKWY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417105",
            "telephone_number": "314-200-1462",
            "fax_number": "314-942-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 OFFICE PKWY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417105",
            "telephone_number": "314-200-1462",
            "fax_number": "314-942-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOROUGHI",
        "first_name": "VAFA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "100645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.