NPIMap

Organization Active NPI

Med Clinical Practice LLC

  • Internal Medicine Physician
  • Clayton, MO
National Provider Identifier
1699516690
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MED CLINICAL PRACTICE LLC
Practice address
401 Corporate Park Dr
Clayton, MO 63105-4201
Phone
(716) 292-6551
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Rameez Malik, MDNPI 1376999417
Title
MD/Owner
Phone
(716) 292-6551

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

401 Corporate Park Dr
Clayton, MO 63105-4201

Mailing address

2025 Zumbehl Rd
Saint Charles, MO 63303-2723
Phone (716) 292-6551

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240718001803 MO Part B Supplier - Clinic/Group Practice 9537605274 Receives reassigned benefits from 17 practitioners
Practice locations: Saint Peters, MO; Clayton, MO; Saint Louis, MO; Kirkwood, MO; Jennings, MO; Ballwin, MO
O20260528002348 IL Part B Supplier - Clinic/Group Practice 9537605274 Receives reassigned benefits from 2 practitioners
Practice locations: O Fallon, IL

National Provider Directory

National Provider Directory

Locations

998 Woods Mill Rd
#L
Ballwin, MO 63011
Phone (636) 288-4149

4455 Duncan Ave
#L
Saint Louis, MO 63110
Phone (636) 288-4149

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1699516690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 ZUMBEHL RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032723",
            "telephone_number": "716-292-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CORPORATE PARK DR",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631054201",
            "telephone_number": "716-292-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CLINICAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "RAMEEZ",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "716-292-6551",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.