NPIMap

Individual provider Active NPI

Bahaeldeen A Laz, M.D.

  • Internal Medicine Physician
  • Saint Charles, MO
National Provider Identifier
1720031784
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1999142855 Issued in MO
Practice address
300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone
(636) 947-5057
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1999142855 MO Primary

Addresses

Primary practice location

300 1St Capitol Dr
Saint Charles, MO 63301-2844

Mailing address

1836 Lackland Hill Pkwy
Att: Credentialing
Saint Louis, MO 63146-3572
Phone (314) 989-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1999142855MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM St. Joseph Hospital West Internal Medicine Past Accepting new patients
Mercy Clinic East Communities Internal Medicine Past Accepting new patients
Emergency Physicians of St. Luke'S, LLC Internal Medicine Past Accepting new patients
SSM Health Care St. Louis Internal Medicine Past Accepting new patients
Clarinda Regional Health Center Internal Medicine Past Accepting new patients
SSM Health Care St. Louis Internal Medicine Past Accepting new patients
Physician Specialists of St Lukes LLC Internal Medicine Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720031784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "ATT: CREDENTIALING",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012844",
            "telephone_number": "636-947-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZ",
        "first_name": "BAHAELDEEN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "1999142855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.