Individual provider Active NPI

Suman Vaddi, M.D.

  • Pulmonary Disease Physician
  • Fenton, MO
National Provider Identifier
1790125318
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2018003024 Issued in MO
Practice address
1011 Bowles Ave Ste 300
Fenton, MO 63026-2387
Phone
(636) 496-5030
NPI assigned
Jun 27, 2013
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2018003024 MO
Internal Medicine Physician 207R00000X 2013017668 MO
Pulmonary Disease Physician 207RP1001X 2018003024 MO Primary
Hospitalist Physician 208M00000X 2018003024 MO

Addresses

Primary practice location

1011 Bowles Ave Ste 300
Fenton, MO 63026-2387

Mailing address

PO Box 955534
Saint Louis, MO 63195-2551

Other practice location 1

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address svaddi312858@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20180803002840 MO Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Hospitalist 4587891445 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Critical Care Services PCGroup PAC ID 8729992060, 32 clinicians

Practice addresses (Care Compare)

1 Cityplace Dr
Suite 570
Saint Louis, MO 63141-7067
Phone (314) 514-6060

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Jul 17, 2018 Accepting new patients
Curators of the University of Missouri CurrentSince Jul 17, 2018 Accepting new patients
SSM Medical Group Inc. CurrentSince Jul 1, 2019 Accepting new patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince May 18, 2020 Accepting new patients
Critical Care Services, P.C. CurrentSince Mar 4, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

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

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1011 Bowles Ave
Ste 300
Fenton, MO 63026
Phone (636) 496-5000

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1 Cityplace Dr
Ste 570
Saint Louis, MO 63141
Phone (314) 514-6060

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Interoperability endpoints

  • Direct secure messaging: svaddi1577334@direct.osumc.edu
  • Direct secure messaging: svaddi312858@direct-ehr-ssmhc.com

Organizations & group practices 7

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 5

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": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1790125318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE 300",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262387",
            "telephone_number": "636-496-5030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652015844",
            "country_code": "US",
            "telephone_number": "573-815-8000",
            "fax_number": "573-815-8556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VADDI",
        "first_name": "SUMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018003024",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2013017668",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2018003024",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2018003024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "svaddi312858@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "svaddi312858@direct-ehr-ssmhc.com",
            "address_1": "1011 Bowles Ave Ste 300",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630262387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1011 Bowles Ave Ste 300",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630262387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.