Organization Active NPI

Family Health Care Medical Center Inc

  • Family Medicine Physician
  • Collinsville, IL
National Provider Identifier
1649693219
Registry record updated Dec 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY HEALTH CARE MEDICAL CENTER INC
Practice address
415 W Main St
Suite 3
Collinsville, IL 62234-3043
Phone
(618) 344-0071
Fax
(618) 344-7793
NPI assigned
Feb 1, 2014
Last updated
Dec 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2023

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

Authorized official

Name
Dr. Raj M Sajid, MDNPI 1265529630
Title
Physician/Owner
Phone
(618) 344-0071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

415 W Main St
Suite 3
Collinsville, IL 62234-3043

Mailing address

PO Box 240042
Ballwin, MO 63024-0042
Phone (618) 344-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140430001797 MO Part B Supplier - Clinic/Group Practice 9739312679 Receives reassigned benefits from 1 practitioner
Practice locations: University City, MO; Saint Louis, MO; Fenton, MO; Creve Coeur, MO; Chesterfield, MO; Black Jack, MO; Eureka, MO
O20160303000532 IL Part B Supplier - Clinic/Group Practice 9739312679 Receives reassigned benefits from 1 practitioner
Practice locations: Collinsville, IL

National Provider Directory

National Provider Directory

Locations

415 W Main St
Ste 3
Collinsville, IL 62234
Phone (618) 343-1639

400 Main St
Fenton, MO 63026

5661 Telegraph Rd
Saint Louis, MO 63129
Phone (314) 846-0606

102 Progress Pkwy
#A
Sullivan, MO 63080
Phone (573) 468-6011

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1391212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701561600000",
    "number": "1649693219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240042",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630240042",
            "telephone_number": "618-344-0071",
            "fax_number": "618-344-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W MAIN ST",
            "address_2": "SUITE 3",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622343043",
            "telephone_number": "618-344-0071",
            "fax_number": "618-344-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CARE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-01",
        "last_updated": "2023-12-03",
        "certification_date": "2023-12-03",
        "status": "A",
        "authorized_official_last_name": "SAJID",
        "authorized_official_first_name": "RAJ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "618-344-0071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.