Individual provider Active NPI

Jamshed Gul Agha, MD

  • Hematology & Oncology Physician
  • Saint Charles, MO
National Provider Identifier
1720041395
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2002016138 Issued in 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
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2002016138 MO Primary

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

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
I20100817001517 MO Practitioner - Hematology/Oncology 0143398545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 1153446471, 30 clinicians

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oncology, LLC Hematology & Oncology CurrentSince May 1, 2020 Accepting new patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group, Inc. Hematology & Oncology CurrentSince Aug 1, 2018 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

10050 Kennerly Rd
Ste 2400
Saint Louis, MO 63128
Phone (314) 849-6066

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

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

Organizations & group practices 4

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 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1720041395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEDICAL DRIVE",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-327-1202",
            "fax_number": "636-327-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD",
            "address_2": "SUITE 180",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048781",
            "telephone_number": "636-442-7300",
            "fax_number": "636-442-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGHA",
        "first_name": "JAMSHED",
        "middle_name": "GUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "2002016138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.