NPIMap

Individual provider Active NPI

Sostanie Takota Enoru, M.D.

  • Interventional Cardiology Physician
  • Jefferson City, MO
National Provider Identifier
1740671254
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2022031212 Issued in MO
Practice address
3501 W Truman Blvd # a
Jefferson City, MO 65109-0514
Phone
(573) 636-0635
NPI assigned
Feb 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2022031212 MO
Interventional Cardiology Physician 207RI0011X 2022031212 MO Primary

Addresses

Primary practice location

3501 W Truman Blvd # a
Jefferson City, MO 65109-0514

Mailing address

PO Box 363
Jefferson City, MO 65102-0363
Phone (573) 636-0635

Other names 1

  • Dr. Sostanie Takota Enoru Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MO2 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
I20200904001584 NY Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 9537404561 Reassigns benefits to 2 organizations
I20220823003529 MO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9537404561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, 165 clinicians

Practice addresses (Care Compare)

2505 Mission Dr
Jefferson City, MO 65109-9508
Phone (573) 681-3000

3501 A W Truman Blvd
Jefferson City, MO 65109-5715
Phone (573) 659-2001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
292675NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
SSM Regional Health Services CurrentSince Sep 6, 2022 Accepting new patients
Amboy Medical Practice PC Internal Medicine CurrentSince May 9, 2020 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Mar 1, 2020 Accepting new patients
SSM Regional Health Services CurrentSince Sep 6, 2022 Accepting new patients
Amboy Medical Practice PC CurrentSince May 9, 2020 Accepting new patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Capital Region Medical Center Cardiovascular Disease Past Accepting new patients
SSM Regional Health Services Hospitalist Past Accepting new patients

Locations

7655 Solutions Ctr
Chicago, IL 60677

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

2701 W Edgewood Dr
Ste 101
Jefferson Cty, MO 65109
Phone (573) 634-5303

3501A W Truman Blvd
Jefferson Cty, MO 65109
Phone (573) 636-0635

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

355 Bard Ave
Bldg 1ST
Staten Island, NY 10310
Phone (718) 720-1222

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: senoru430662@direct-ehr-ssmhc.com
  • Direct secure messaging: senoru1052183@nychhc.direct-ci.com

Organizations & group practices 9

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 7

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": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1740671254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 363",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651020363",
            "telephone_number": "573-636-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W TRUMAN BLVD # A",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090514",
            "telephone_number": "573-636-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENORU",
        "first_name": "SOSTANIE",
        "middle_name": "TAKOTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-05",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2022031212",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2022031212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOSTANIE",
            "last_name": "TAKOTA ENORU",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.