NPIMap

Individual provider Active NPI

Gautum Agarwal, MD

  • Urology Physician
  • Saint Louis, MO
National Provider Identifier
1780880633
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2015018625 Issued in MO
Practice address
607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone
(314) 251-8850
NPI assigned
Jun 26, 2007
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2015018625 MO Primary

Addresses

Primary practice location

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219

Mailing address

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone (314) 251-8850

Other practice location 1

701 S New Ballas Rd Ste 330
Saint Louis, MO 63141-8702
Phone (314) 251-8850

Other identifiers 1

IdentifierTypeStateIssuer
1780880633MedicaidMO

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
I20151001000884 MO Practitioner - Urology 4183932791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Saint Louis University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Urology LLCGroup PAC ID 5395768253, 26 clinicians

Practice addresses (Care Compare)

607 S New Ballas Rd
Suite 3100
St Louis, MO 63141-8219
Phone (314) 251-8850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Urology LLC Urology CurrentSince Sep 28, 2015 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 18, 2015 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 18, 2015 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

12700 Southfork Rd
Ste 260
Saint Louis, MO 63128
Phone (314) 251-8850

607 S New Ballas Rd
Ste 3100
Saint Louis, MO 63141
Phone (314) 251-4260

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

701 S New Ballas Rd
Ste 330
Saint Louis, MO 63141
Phone (314) 251-8850

Interoperability endpoints

  • Direct secure messaging: gagarwal721568@directc.mercy.net

Organizations & group practices 4

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 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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1780880633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 S New Ballas Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418702",
            "country_code": "US",
            "telephone_number": "314-251-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "GAUTUM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2015018625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780880633",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.