Individual provider Active NPI

Paul J Hauptman, MD

  • Cardiovascular Disease Physician
  • St Louis, MO
National Provider Identifier
1619987930
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
115045 Issued in MO
Practice address
3635 Vista Ave at Grand Blvd
St Louis, MO 63110
Phone
(314) 577-8896
Fax
(314) 268-5138
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 115045 MO Primary

Addresses

Primary practice location

3635 Vista Ave at Grand Blvd
St Louis, MO 63110

Mailing address

3691 Rutger Ave
St Louis, MO 63110
Phone (314) 977-4440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190122001472 TN Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1850398223 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115045MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System Inc CurrentSince Jan 1, 2020 Accepting new patients
University Health System, Inc Current Accepting new patients
Knoxville Cardiovascular Group PC Cardiovascular Disease Current Accepting new patients
University Health System Inc Cardiovascular Disease CurrentSince Jan 1, 2020 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Curators of the University of Missouri Past Accepting new patients
The Curators of the University of Missouri Past Accepting new patients

Locations

2681 Andersonville Hwy
Ste 102
Clinton, TN 37716
Phone (865) 494-5960

1940 Alcoa Hwy
Ste 310
Knoxville, TN 37920
Phone (865) 305-9873

1928 Alcoa Hwy
Ste B100
Knoxville, TN 37920
Phone (865) 305-6570

1940 Alcoa Hwy
Ste E310
Knoxville, TN 37920
Phone (865) 544-4280

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

Organizations & group practices 7

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1619987930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3691 RUTGER AVE",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-977-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE AT GRAND BLVD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-577-8896",
            "fax_number": "314-268-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPTMAN",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "115045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

Verify at the official NPI Registry.