Individual provider Active NPI

Bhajanlal S Dara, M.D.

  • Nephrology Physician
  • Saint Louis, MO
National Provider Identifier
1699708016
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
105728 Issued in MO
Practice address
777 S New Ballas Rd Ste 328W
Saint Louis, MO 63141-8748
Phone
(314) 869-0370
Fax
(314) 869-5098
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 105728 MO
Nephrology Physician 207RN0300X 105728 MO Primary

Addresses

Primary practice location

777 S New Ballas Rd Ste 328W
Saint Louis, MO 63141-8748

Mailing address

1234 Lay Rd
Saint Louis, MO 63124-1872
Phone (314) 869-0370

Other practice location 1

4100 Union Blvd Unit B1
Saint Louis, MO 63115-1225
Phone (314) 869-0370

Other practice location 2

23 N Oaks Plz Ste 204
Saint Louis, MO 63121-2917
Phone (314) 869-0370

Other practice location 3

1224 Graham Rd Ste 1111
Florissant, MO 63031-8028
Phone (314) 869-0370

Other practice location 4

4100 Union Blvd Unit B
Saint Louis, MO 63115-1225
Phone (314) 531-1112

Other identifiers 3

IdentifierTypeStateIssuer
506118603MedicaidMO
207695529MedicaidMO
507043701MedicaidMO

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
I20100105000114 MO Practitioner - Internal MedicinePractitioner - Nephrology 2062490139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro St Louis Renal Services IncGroup PAC ID 0941224547, 2 clinicians

Practice addresses (Care Compare)

4100 Union Blvd
Saint Louis, MO 63115-1225
Phone (314) 869-0370

Hospital & facility affiliations

  • Gateway St Louis Dialysis, LLC Dialysis facility, Saint Louis, MO, CCN 262642
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105728MOMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical Associates, LLC Internal Medicine CurrentSince Mar 21, 2008 Accepting new patients

Locations

1224 Graham Rd
Ste 1111
Florissant, MO 63031
Phone (314) 837-3720

4100 Union Blvd
#B
Saint Louis, MO 63115
Phone (314) 531-1112

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1699708016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 LAY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241872",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD STE 328W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418748",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Union Blvd Unit B1",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631151225",
            "country_code": "US",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 N Oaks Plz Ste 204",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631212917",
            "country_code": "US",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1224 Graham Rd Ste 1111",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630318028",
            "country_code": "US",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 Union Blvd Unit B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631151225",
            "country_code": "US",
            "telephone_number": "314-531-1112",
            "fax_number": "314-288-0674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARA",
        "first_name": "BHAJANLAL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "105728",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "105728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506118603",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207695529",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507043701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.