NPIMap

Individual provider Active NPI

Bharathi Raju, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Louis, MO
National Provider Identifier
1720078843
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2001005643 Issued in MO
Practice address
12900 Tesson Ferry Rd Ste 101
Saint Louis, MO 63128-3002
Phone
(314) 843-4848
Fax
(866) 510-2730
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2001005643 MO Primary

Addresses

Primary practice location

12900 Tesson Ferry Rd Ste 101
Saint Louis, MO 63128-3002

Mailing address

12900 Tesson Ferry Rd Ste 101
Saint Louis, MO 63128-3002
Phone (314) 843-4848

Other identifiers 1

IdentifierTypeStateIssuer
207175407MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051014000840 MO Practitioner - EndocrinologyPractitioner - Internal Medicine 5294751632 Reassigns benefits to 2 organizations
I20140620001794 IL Practitioner - Endocrinology 5294751632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South County Endocrinology and Obesity Medicine LLCGroup PAC ID 2668619669, 3 clinicians

Practice addresses (Care Compare)

12900 Tesson Ferry Rd
Suite 101
Saint Louis, MO 63128-3002
Phone (314) 843-4848

Hospital & facility affiliations

  • Fayette County Hospital Hospital, Vandalia, IL, CCN 141346
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • HSHS Holy Family Hospital Inc Hospital, Greenville, IL, CCN 140137

Merit-based Incentive Payment System (MIPS)

Final score
99.57 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
77.96

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince May 1, 2014 Accepting new patients
Iron County Hospital District CurrentSince Dec 1, 2017 Accepting new patients
South County Endocrinology and Obesity Medicine LLC CurrentSince Nov 8, 2012 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince May 1, 2014 Accepting new patients
Iron County Hospital District CurrentSince Dec 1, 2017 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Sarah Bush Lincoln Health Center Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

650 W Taylor St
Fl 2
Vandalia, IL 62471
Phone (217) 342-3400

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

12818 Tesson Ferry Rd
Ste 104
Saint Louis, MO 63128
Phone (314) 843-4848

12900 Tesson Ferry Rd
Ste 101
Saint Louis, MO 63128
Phone (314) 252-0708

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1720078843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 TESSON FERRY RD STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283002",
            "telephone_number": "314-843-4848",
            "fax_number": "866-510-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 TESSON FERRY RD STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283002",
            "telephone_number": "314-843-4848",
            "fax_number": "866-510-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJU",
        "first_name": "BHARATHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2001005643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207175407",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.