Individual provider Active NPI

Pooja Parth Vyas, D.O.

  • Hospitalist Physician
  • Saint Louis, MO
National Provider Identifier
1740674928
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2019017131 Issued in MO
Practice address
11133 Dunn Rd Ste 2427
Saint Louis, MO 63136-6163
Phone
(314) 653-5643
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2019017131 MO Primary

Addresses

Primary practice location

11133 Dunn Rd Ste 2427
Saint Louis, MO 63136-6163

Mailing address

11133 Dunn Rd Ste 2427
Saint Louis, MO 63136-6163
Phone (314) 653-5643

Other names 1

  • Pooja Umesh Shah Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20200322000140 MO Practitioner - HospitalistPractitioner - Internal Medicine 3476856659 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Jun 7, 2023 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jun 7, 2023 Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

11133 Dunn Rd
Ste 2427
Saint Louis, MO 63136
Phone (314) 653-5643

11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784

Interoperability endpoints

  • Direct secure messaging: pvyas1047909@direct.carenet.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1740674928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD STE 2427",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "314-653-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD STE 2427",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "314-653-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "POOJA",
        "middle_name": "PARTH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2019017131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11133 Dunn Rd Ste 2427",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "POOJA",
            "last_name": "SHAH",
            "middle_name": "UMESH",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.