Individual provider Active NPI

Nadeem Aslam Sufi, MD

  • Hospitalist Physician
  • Saint Louis, MO
National Provider Identifier
1629041553
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2002010430 Issued in MO
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-5772
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2002010430 MO Primary
Internal Medicine Physician 207R00000X 2002010430 MO

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Other practice location 1

12303 DePaul Drive
Bridgeton, MO 63044
Phone (314) 317-0600

Other identifiers 2

IdentifierTypeStateIssuer
208371708MedicaidMO
1629041553MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20100626000243 MO Practitioner - HospitalistPractitioner - Internal Medicine 8123938933 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Internal Medicine CurrentSince Apr 1, 2021 Accepting new patients
Physician Groups LC CurrentSince Apr 1, 2021 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jun 12, 2017 Accepting new patients
Missouri Baptist Medical Center Past Accepting new patients

Locations

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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 2

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1629041553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12303 DePaul Drive",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "63044",
            "country_code": "US",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUFI",
        "first_name": "NADEEM",
        "middle_name": "ASLAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2002010430",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2002010430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208371708",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629041553",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.