Med Clinical Practice LLC
Organization Active NPI Internal Medicine Physician · Clayton, MO
NPI 1699516690 · NPPES record last updated Jun 4, 2024
Key facts
- NPI
- 1699516690
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 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
- Organization subpart
- No
Authorized official
- Name
- Rameez Malik, MD
- Title
- MD/Owner
- Phone
- (716) 292-6551
Practitioners 17
-
Elena A Barrow, FNP
-
Rachel A Didion, FNP
-
Victoria Gelfand, NP
-
Megan Houlahan, AGNP
-
Elise Danielle Maletich Hirsekorn, DNP, FNP-BC
-
Rameez Malik, M.D.
-
Muhammad Naseeruddin, M.D.
-
Maisa A Nazzal, M.D.
-
Abdul Rauf, M.D.
-
Salman Saeed, M.D.
-
Julia Marie Taylor, APN
-
Muhammad Umar, DO
-
Noura Zakari, NP
-
Gregory Thomas Bismack, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Locations
998 Woods Mill Rd
#L
Ballwin, MO 63011
Phone (636) 288-4149
401 Corporate Park Dr
Saint Louis, MO 63105
Phone (314) 725-7447
4455 Duncan Ave
#L
Saint Louis, MO 63110
Phone (636) 288-4149
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
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
Other providers in Clayton, MO
- Katie Bridges McDaniel
- Jennifer Elizabeth McFarland
- Joan M McGinnis
- Elizabeth A McMullen
- Mdpmo Physicians, P.C.
- Medi-Plex DME Plus, LLC
- Medical Arts Pharmacy
- Medical West Healthcare Center LLC
- Medical West Podiatry LTD Medical West BLDG
- Medical West Respiratory Pharmacy, LLC
All providers in Clayton, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.