Individual provider Active NPI

Manokiran Patri, M.D.

  • Infectious Disease Physician
  • Saint Charles, MO
National Provider Identifier
1649204173
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
2009027341 Issued in MO
Practice address
330 1St Capitol Dr Ste 260
Saint Charles, MO 63301-2888
Phone
(636) 925-0900
Fax
(636) 925-0960
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-104049 IL
Infectious Disease Physician 207RI0200X 2009027341 MO Primary

Addresses

Primary practice location

330 1St Capitol Dr Ste 260
Saint Charles, MO 63301-2888

Mailing address

PO Box 504934
Saint Louis, MO 63150-4934

Other identifiers 1

IdentifierTypeStateIssuer
036-104049OtherILMEDICAL LICENSE NUMBER

Other names 1

  • Dr. Manokiran Buddhiraju Former name

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
I20090928000044 MO Practitioner - Infectious DiseasePractitioner - Internal Medicine 3971594748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Diseases PCGroup PAC ID 6305880956, 10 clinicians

Practice addresses (Care Compare)

10004 Kennerly Rd
Suite 171B
Saint Louis, MO 63128-2141

300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone (636) 947-5000

330 1St Capitol Dr
Suite 260
St Charles, MO 63128
Phone (636) 925-0900

400 1St Capitol Dr
Suite 300
Saint Charles, MO 63301-2883
Phone (636) 925-0900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-104049ILMDSpecialist
2009027341MOMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Infectious Disease Consultants, S.C. Infectious Disease PastSince Jan 1, 2001 Accepting new patients
Infectious Disease, PC Infectious Disease PastSince Oct 1, 2009 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: manokiranpatri@id.direct.emds.com

Organizations & group practices 3

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 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1649204173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504934",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631504934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 1ST CAPITOL DR STE 260",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012888",
            "telephone_number": "636-925-0900",
            "fax_number": "636-925-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRI",
        "first_name": "MANOKIRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-104049",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2009027341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "036-104049",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANOKIRAN",
            "last_name": "BUDDHIRAJU",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.