NPIMap

Organization Active NPI

Infectious Diseases PC

  • Infectious Disease Physician
  • Saint Louis, MO
National Provider Identifier
1720055452
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INFECTIOUS DISEASES PC
Practice address
10004 Kennerly Road
#171B
St. Louis, MO 63128
Phone
(314) 821-0900
Fax
(800) 556-8932
NPI assigned
Mar 1, 2006
Last updated
Aug 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Authorized official

Name
Aamina B Akhtar, MDNPI 1124095831
Title
President
Phone
(314) 821-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X Primary
Adult Health Nurse Practitioner 363LA2200X

Addresses

Primary practice location

10004 Kennerly Road
#171B
St. Louis, MO 63128

Mailing address

10004 Kennerly Road
#171B
St. Louis, MO 63128
Phone (314) 821-0900

Other identifiers 1

IdentifierTypeStateIssuer
506049501MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614001062 MO Part B Supplier - Clinic/Group Practice 6305880956 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: St Charles, MO; Saint Louis, MO; Saint Charles, MO; Lake St Louis, MO; Festus, MO; Bridgeton, MO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Infectious Disease PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10004 Kennerly Rd
Ste 171B
Saint Louis, MO 63128
Phone (314) 821-0900

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1720055452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY ROAD",
            "address_2": "#171B",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-821-0900",
            "fax_number": "800-556-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY ROAD",
            "address_2": "#171B",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-821-0900",
            "fax_number": "800-556-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "AKHTAR",
        "authorized_official_first_name": "AAMINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-821-0900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506049501",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.