Tipu Sultan, M.D.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

R7234 Issued in MO

Practice address

11585 W Florissant Ave
Florissant, MO 63033-6740

Phone

(314) 921-5600

Fax

(314) 921-8273

NPI assigned

Dec 21, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 1998 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629132683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11585 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336740",
            "telephone_number": "314-921-5600",
            "fax_number": "314-921-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11585 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336740",
            "telephone_number": "314-921-5600",
            "fax_number": "314-921-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTAN",
        "first_name": "TIPU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MO",
            "license": "R7234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Renee Stroot, LPTA
• Alissa Leigh Struble, FNP
• Julie Marie Sturm, MD
• Gregory A Stynowick, MD
• Mark Daniel Sueoka, DDS
• Mikkaela Suntrup, PTA
• Support Independence LLC
• Support Innovations Inc.
• Support Innovations Plus
• Supportive Living Consumer Direct

• Allergy Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Allergy Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.