Jamshed Gul Agha, MD
Individual provider Active NPI Hematology & Oncology Physician · Saint Charles, MO
NPI 1720041395 · NPPES record last updated Sep 10, 2012
Key facts
- NPI
- 1720041395
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- License
- 2002016138 (MO)
- Practice address
- 1475 Kisker Rd
Suite 180
Saint Charles, MO 63304-8781 - Phone
- (636) 442-7300
- Fax
- (636) 442-7319
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Hematology/Oncology
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mercy Clinic Oncology LLC
Practice addresses (Care Compare)
10050 Kennerly Rd
Suite 2400
Saint Louis, MO 63128-2106
Phone (314) 849-6066
10050 Kennerly Rd
Suite 2400
Saint Louis, MO 63128-2193
Phone (314) 849-6066
607 S New Ballas Rd
Saint Louis, MO 63141-8219
Phone (314) 251-4400
615 S New Ballas Rd 5TH Floor
St Louis, MO 63141-8221
901 Patients 1St Dr
Washington, MO 63090-4700
Phone (636) 390-1600
Hospital & facility affiliations
- Mercy Hospital St Louis
- Mercy Hospital South
- Mercy Hospital Jefferson
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100817001517 | MO | Practitioner - Hematology/Oncology | 0143398545 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group Inc. | Current |
Accepting new patients | |
| SSM Medical Group, Inc. | Hematology & Oncology | Current |
Accepting new patients |
| Mercy Clinic Oncology, LLC | Hematology & Oncology | Current |
Accepting new patients |
| Mercy Hospitals East Communities | Past | Accepting new patients |
Locations
1015 Bowles Ave
Ste 1000
Fenton, MO 63026
Phone (636) 390-1400
400 Medical Plz
Ste 10
Lake St Louis, MO 63367
Phone (636) 625-6052
400 Medical Plz
Ste 100
Lake St Louis, MO 63367
Phone (636) 639-8600
1475 Kisker Rd
Ste 180
Saint Charles, MO 63304
Phone (636) 442-7300
1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
10050 Kennerly Rd
Ste 2400
Saint Louis, MO 63128
Phone (314) 849-6066
3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100
607 S New Ballas Rd
Ste 33
Saint Louis, MO 63141
Phone (314) 251-4400
901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500
500 Medical Dr
Wentzville, MO 63385
Phone (636) 327-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 2002016138 | MO | Yes |
Addresses
Primary practice location
1475 Kisker Rd
Suite 180
Saint Charles, MO 63304-8781
Mailing address
500 Medical Drive
Wentzville, MO 63385
Phone (636) 327-1202
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1360100 | Other | UHC | |
| 173279 | Other | MO | BCBS |
| 5469243 | Other | AETNA | |
| 900004419 | Other | RR MEDICARE | |
| 205972300 | Medicaid | MO | |
| 143463 | Other | GHP | |
| 633997 | Other | HEALTHLINK |
Other providers in Saint Charles, MO
- Lisa Ann Adams
- Nadira Adil
- Adio Family Chiropractic, LLC
- Adoreu Healthcare Services LLC
- Ag Management Group LLC
- Aging Consult Inc.
- Aiding in Home,LLC
- Alan C Honerkamp Inc
- Alan Presswood DC PC
- Rachael Albert
All providers in Saint Charles, MO · Hematology & Oncology 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 Sep 10, 2012. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.