Individual provider Active NPI

Sekhar Vangala, M.D.

  • Psychiatry Physician
  • Farmington, MO
National Provider Identifier
1679774962
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2009001635 Issued in MO
Practice address
1010 W Columbia St
Farmington, MO 63640-2902
Phone
(573) 218-6771
NPI assigned
May 31, 2007
Last updated
Oct 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2009001635 MO Primary

Addresses

Primary practice location

1010 W Columbia St
Farmington, MO 63640-2902

Mailing address

650 Turtle Creek Dr
Saint Louis, MO 63141-6502
Phone (314) 205-3205

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
I20090925000105 MO Practitioner - Psychiatry 7113073628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of MissouriGroup PAC ID 1456254226, 48 clinicians

Practice addresses (Care Compare)

1010 W Columbia St
Farmington, MO 63640-2902
Phone (573) 218-6792

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009001635MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Psychiatry CurrentSince Aug 9, 2009 Accepting new patients
State of Missouri Psychiatry CurrentSince Aug 9, 2009 Accepting new patients

Locations

1010 W Columbia St
Farmington, MO 63640
Phone (573) 218-6792

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1679774962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 TURTLE CREEK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416502",
            "telephone_number": "314-205-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W COLUMBIA ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402902",
            "telephone_number": "573-218-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGALA",
        "first_name": "SEKHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2009001635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.