Active NPI
Nand K Kodwani, MD
- Anesthesiology Physician
- Bridgeton, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD114524
- Practice address
- 12303 Depaul Dr
Bridgeton, MO 63044 - Phone
- (314) 344-7049
- Fax
- (314) 344-7073
- NPI assigned
- Oct 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036.146368 | IL | |
| Anesthesiology Physician | 207L00000X | MD114524 | MO | Primary |
Addresses
Primary practice location
12303 Depaul Dr
Bridgeton, MO 63044
Mailing address
12303 Depaul Dr
Bridgeton, MO 63044
Phone (314) 344-7049
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203876719 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120
Hospital & facility affiliations
- HSHS St Elizabeth'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.146368 | IL | MD | Anesthesiology Physician |
| MD114524 | MO | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Slu Hospital Anesthesia Physician Billing, LLC | Anesthesiology | Current | Accepting new patients |
| Aim Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
| North American Partners in Anesthesia (Illinois), LLC | Anesthesiology | Current | Accepting new patients |
| Eye Anesthesia LLC | Anesthesiology | Past | Accepting new patients |
| Northwest Anesthesia LTD | Anesthesiology | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
1215 Franciscan Dr
Litchfield, IL 62056
Phone (217) 324-2191
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511
3550 McKelvey Rd
Bridgeton, MO 63044
Phone 31474109114048
1101 W Gannon Dr
Festus, MO 63028
Phone (636) 931-5997
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
Organizations & group practices 5
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.
-
- Anesthesiology Physician
- Oak Park, IL
- NPI 1699032524
-
- Anesthesiology Physician
- Bridgetown, MO
- NPI 1245685601
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1407232804
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1528334182
-
- Anesthesiology Physician
- Bridgeton, MO
- NPI 1114917374
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- O Fallon, IL
- NPI 1629057302
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": "1677024000000",
"number": "1720078884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12303 DEPAUL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "63044",
"telephone_number": "314-344-7049",
"fax_number": "314-344-7073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12303 DEPAUL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "63044",
"telephone_number": "314-344-7049",
"fax_number": "314-344-7073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODWANI",
"first_name": "NAND",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036.146368",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "MD114524",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203876719",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.