NPIMap

Individual provider Active NPI

Bhaskar Gowda, MD

  • Psychiatry Physician
  • Sullivan, MO
National Provider Identifier
1750367967
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2002031642 Issued in MO
Practice address
101 Progress Pkwy
Sullivan, MO 63080-2359
Phone
(888) 403-1071
NPI assigned
Dec 20, 2005
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2002031642 MO Primary

Addresses

Primary practice location

101 Progress Pkwy
Sullivan, MO 63080-2359

Mailing address

15992 Trowbridge Rd
Chesterfield, MO 63017-7339

Other practice location 1

704 E Highway 28
Owensville, MO 65066-1588
Phone (888) 403-1071

Other identifiers 1

IdentifierTypeStateIssuer
209022417MedicaidMO

Other names 1

  • Bhaskar Yadurayagowda Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000226 MO Practitioner - PsychiatryPractitioner - Neurology 7416910849 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians
Compass Health IncGroup PAC ID 1951206754, 317 clinicians
SSM Regional Health ServicesGroup PAC ID 8921917352, 165 clinicians

Practice addresses (Care Compare)

1000 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

1198 Martin St
Cuba, MO 65453-1656
Phone (844) 853-8937

1800 Community
Clinton, MO 64735-8804
Phone (888) 403-1071

227 Metro Dr
Jefferson City, MO 65109-1134
Phone (844) 853-8937

2505 Mission Dr
Jefferson City, MO 65109-9508
Phone (573) 681-3249

2701 W Edgewood Dr
101 SSM Health Medical Group Behaviora
Jefferson City, MO 65109-5890
Phone (573) 634-5303

311 N Spring St
Steelville, MO 65565-5089
Phone (573) 775-5815

860 Lynn St
Lebanon, MO 65536-3810
Phone (888) 403-1071

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002031642MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Regional Health Services CurrentSince Sep 10, 2008 Accepting new patients
Pcrmc Medical Group, Inc CurrentSince Dec 1, 2023 Accepting new patients
Compass Health, Inc CurrentSince Mar 15, 2004 Accepting new patients
Phelps County Regional Medical Center CurrentSince Dec 1, 2023 Accepting new patients
Compass Health, Inc CurrentSince Mar 15, 2004 Accepting new patients
Phelps County Regional Medical Center CurrentSince Dec 1, 2023 Accepting new patients
SSM Regional Health Services CurrentSince Sep 10, 2008 Accepting new patients
Hope Psychiatric Services LLC Psychiatry CurrentSince Jul 1, 2014 Accepting new patients
Missouri Baptist Hospital of Sullivan Past Accepting new patients
Advanced Psychiatric Services Psychiatry Past Accepting new patients
SSM Regional Health Services Past Accepting new patients
Clearview Outpatient Services Inc. Past Accepting new patients
Lake Behavioral Health Associates, LLC Past Accepting new patients

Locations

7655 Solutions Ctr
Chicago, IL 60677

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

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

704 E Highway 28
Owensville, MO 65066
Phone (573) 437-2959

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

311 N Spring St
Steelville, MO 65565
Phone (573) 260-8850

101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555

1780 Old Highway 50 E
Ste 111
Union, MO 63084
Phone (636) 584-0305

307 N Main St
Windsor, MO 65360
Phone (660) 647-2182

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 8

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1750367967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15992 TROWBRIDGE RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROGRESS PKWY",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802359",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 E Highway 28",
            "address_purpose": "LOCATION",
            "city": "Owensville",
            "state": "MO",
            "postal_code": "650661588",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOWDA",
        "first_name": "BHASKAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2002031642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209022417",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BHASKAR",
            "last_name": "YADURAYAGOWDA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sullivan, MO

Sources for this page

Verify at the official NPI Registry.