Metro St Louis Renal Services, Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

105728 Issued in MO

Legal business name

METRO ST LOUIS RENAL SERVICES, INC

Practice address

777 S New Ballas Rd Ste 328W
Saint Louis, MO 63141-8748

Phone

(314) 869-0370

Fax

(314) 869-5098

NPI assigned

Mar 13, 2008

Last updated

Mar 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bhajan Shewaldas Dara, MD

Title

President

Phone

(314) 869-0370

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ameesh Dara, D.O.

  • Nephrology Physician
  • Saint Louis, MO
  • NPI 1417367244
  Medicare reassignment Care Compare group
• Bhajanlal S Dara, M.D.

  • Nephrology Physician
  • Saint Louis, MO
  • NPI 1699708016
  Medicare reassignment Care Compare group
• Andrew Cronson Dickler, M.D.

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1306892468
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647648000000",
    "number": "1811168263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 LAY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241872",
            "telephone_number": "314-323-4492",
            "fax_number": "800-469-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD STE 328W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418748",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Union Blvd Unit B1",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631151225",
            "country_code": "US",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1224 Graham Rd Ste 1111",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630318028",
            "country_code": "US",
            "telephone_number": "314-869-0370",
            "fax_number": "314-869-5098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "METRO ST LOUIS RENAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A",
        "authorized_official_last_name": "DARA",
        "authorized_official_first_name": "BHAJAN",
        "authorized_official_middle_name": "SHEWALDAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-869-0370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "105728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506118603",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Metro Heart Group of St. Louis, Inc
• Metro Medical Clinic South LLC
• Metro Medical Clinic, LLC
• Metro Medical Institute
• Metro Saint Louis Dialysis Center
• Metro St Louis Surgery Center LLC
• Metro St. Louis Dialysis - Florissant LLC
• Metro Urgent Care LLC
• Metropolitan Neurology, LTD
• Metropolitan Orthopedics, LTD.

• Nephrology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nephrology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.