Individual provider Active NPI

Hiralben B Gandhi, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1710423710
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020028165 Issued in MO
Practice address
3844 S Lindbergh Blvd Ste 120
Saint Louis, MO 63127-1369
Phone
(314) 525-0490
NPI assigned
Jan 13, 2017
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.015422 IL
Family Nurse Practitioner 363LF0000X 2020028165 MO Primary

Addresses

Primary practice location

3844 S Lindbergh Blvd Ste 120
Saint Louis, MO 63127-1369

Mailing address

3844 S Lindbergh Blvd Ste 120
Saint Louis, MO 63127-1369
Phone (314) 525-0490

Other practice location 1

830 Carnaby Ct
Schaumburg, IL 60194-2205
Phone (847) 987-5573

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170220000498 IL Practitioner - Nurse Practitioner 1658654579 Reassigns benefits to 2 organizations
I20210108000807 MO Practitioner - Nurse Practitioner 1658654579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

3844 S Lindbergh Blvd
Suite 120
Saint Louis, MO 63127-1369
Phone (314) 525-0490

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.015422ILMDFamily Nurse Practitioner
2020028165MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Family CurrentSince Feb 9, 2017 Accepting new patients
Primary Care Services CurrentSince Sep 2, 2019 Accepting new patients
Physician Groups LC CurrentSince Feb 1, 2021 Accepting new patients
Physician Groups LC CurrentSince Feb 1, 2021 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706

2500 S Highland Ave
Ste 230
Lombard, IL 60148
Phone (630) 429-9000

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3844 S Lindbergh Blvd
Ste 120
Saint Louis, MO 63127
Phone (314) 525-0434

Organizations & group practices 5

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 1

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": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1710423710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3844 S LINDBERGH BLVD STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271369",
            "telephone_number": "314-525-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3844 S LINDBERGH BLVD STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271369",
            "telephone_number": "314-525-0490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Carnaby Ct",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601942205",
            "country_code": "US",
            "telephone_number": "847-987-5573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "HIRALBEN",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015422",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020028165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3844 S Lindbergh Blvd Ste 120",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631271369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.