NPIMap

Individual provider Active NPI

Gopal Krishnan, M.D

  • Nephrology Physician
  • Saint Louis, MO
National Provider Identifier
1780658716
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2001001580 Issued in MO
Practice address
10004 Kennerly Rd Ste 361B
Saint Louis, MO 63128-2141
Phone
(314) 843-3449
Fax
(314) 843-8762
NPI assigned
Feb 15, 2006
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2001001580 MO
Nephrology Physician 207RN0300X 2001001580 MO Primary

Addresses

Primary practice location

10004 Kennerly Rd Ste 361B
Saint Louis, MO 63128-2141

Mailing address

PO Box 840132
Kansas City, MO 64184-0132
Phone (314) 843-3449

Other identifiers 2

IdentifierTypeStateIssuer
390008372OtherRAILROAD MEDICARE
036099454MedicaidIL

Other names 1

  • Gopal Pandurangan Former 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
I20080226000259 MO Practitioner - NephrologyPractitioner - Internal Medicine 5890749717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Nephrology Associates LLCGroup PAC ID 8921064031, 2 clinicians

Practice addresses (Care Compare)

10004 Kennerly Rd
Suite 361B
Saint Louis, MO 63128-2141
Phone (314) 843-3449

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Alliance, LLC Nephrology PastSince Aug 1, 2002 Accepting new patients
Nephrology and Hypertension Specialists, LLC Nephrology PastSince Jan 28, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gkrishnan9846@direct-ehr-ssmhc.com
  • Direct secure messaging: gopal.krishnan@slna.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HGAIBA/Endpoint/HGAIBA

Organizations & group practices 3

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.

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1780658716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840132",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641840132",
            "telephone_number": "314-843-3449",
            "fax_number": "314-843-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 361B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-843-3449",
            "fax_number": "314-843-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "GOPAL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2001001580",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2001001580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390008372",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099454",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GOPAL",
            "last_name": "PANDURANGAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.