Active NPI
Kishore Maganty, M.D.
- Gastroenterology Physician
- Saint Louis, MO
National Provider Identifier
1790908820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 2013012523
- Practice address
- 522 N New Ballas Rd Ste 210
Saint Louis, MO 63141-6829 - Phone
- (314) 328-5930
- Fax
- (314) 328-5933
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 2013012523 | MO | Primary |
Addresses
Primary practice location
522 N New Ballas Rd Ste 210
Saint Louis, MO 63141-6829
Mailing address
522 N New Ballas Rd Ste 210
Saint Louis, MO 63141-6829
Phone (314) 328-5930
Other practice location 1
510 Fullerton Rd
Swansea, IL 62226-2970
Phone (314) 328-5930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200005035 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
325 W Lincoln St
Belleville, IL 62220-1921
Phone (314) 328-5930
522 N New Ballas Rd
Suite 210
Saint Louis, MO 63141-6829
Phone (314) 328-5930
Hospital & facility affiliations
- Missouri Baptist Medical Center
- St Lukes Hospital
- Phelps County Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 22.27 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 74.22
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 74 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 495 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastroenterology Care LLC | Gastroenterology | Current | Accepting new patients |
Locations
325 W Lincoln St
Belleville, IL 62220
Phone (618) 225-2299
522 N New Ballas Rd
Ste 210
Saint Louis, MO 63141
Phone (314) 219-7420
Interoperability endpoints
- kmaganty134729@direct.carenet.org
Organizations & group practices 1
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.
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1487663506
-
- Rehabilitation Hospital Unit
- Rolla, MO
- NPI 1346287455
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
-
- General Acute Care Hospital
- Chesterfield, MO
- NPI 1346251543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716249600000",
"number": "1790908820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 N NEW BALLAS RD STE 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416829",
"telephone_number": "314-328-5930",
"fax_number": "314-328-5933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 N NEW BALLAS RD STE 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416829",
"telephone_number": "314-328-5930",
"fax_number": "314-328-5933"
}
],
"practiceLocations": [
{
"address_1": "510 Fullerton Rd",
"address_purpose": "LOCATION",
"city": "Swansea",
"state": "IL",
"postal_code": "622262970",
"country_code": "US",
"telephone_number": "314-328-5930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAGANTY",
"first_name": "KISHORE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MO",
"license": "2013012523",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200005035",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.