Individual provider Active NPI

Milan Gimantha Kahanda, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Saint Louis, MO
National Provider Identifier
1811301740
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
2022015523 Issued in MO
Practice address
10012 Kennerly Rd Ste 202
Saint Louis, MO 63128-2197
Phone
(314) 692-2807
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2022015523 MO
Clinical Cardiac Electrophysiology Physician 207RC0001X 2022015523 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd Ste 202
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd Ste 202
Saint Louis, MO 63128-2197
Phone (314) 692-2807

Other practice location 1

1001 S Kirkwood Rd Ste 310
Saint Louis, MO 63122-7250
Phone (314) 692-2807

Other practice location 2

10012 Kennerly Rd Ste 300
Saint Louis, MO 63128-2197
Phone (314) 692-2807

Other practice location 3

4280 Mid America Ln Ste 10
Saint Louis, MO 63129-1202
Phone (636) 692-2807

Other practice location 4

10004 Kennerly Rd Ste 115A
Saint Louis, MO 63128-5106
Phone (314) 692-2807

Other practice location 5

12200 Weber Hill Rd Ste 100
Saint Louis, MO 63127-1569
Phone (314) 692-2807

Other practice location 6

7345 Watson Rd # Ll1
Saint Louis, MO 63119-9804
Phone (314) 692-2807

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20220818001198 MO Practitioner - Cardiac Electrophysiology 8325267156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 202
Saint Louis, MO 63128-2197
Phone (314) 692-2807

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022015523MOMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Heart and Vascular, LLC Cardiovascular Disease CurrentSince Oct 7, 2024 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Aug 1, 2022 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Aug 1, 2022 Accepting new patients
Saint Luke'S Physician Group Inc Internal Medicine Past Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients

Locations

1390 US Highway 61
Ste N1500
Crystal Cty, MO 63028
Phone (636) 933-5055

1225 Graham Rd
Ste C-2310
Florissant, MO 63031
Phone (314) 953-6300

11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

10012 Kennerly Rd
Ste 202
Saint Louis, MO 63128
Phone (314) 692-2807

4280 Mid America Ln
Ste 10
Saint Louis, MO 63129
Phone (314) 692-2807

10004 Kennerly Rd
Ste 115A
Saint Louis, MO 63128
Phone (314) 525-1538

7345 Watson Rd
#1
Saint Louis, MO 63119
Phone (314) 692-2807

10012 Kennerly Rd
Ste 300
Saint Louis, MO 63128
Phone (314) 842-0602

12200 Weber Hill Rd
Ste 100
Saint Louis, MO 63127
Phone (314) 698-2400

1001 S Kirkwood Rd
Ste 310
Saint Louis, MO 63122
Phone (314) 692-2807

625 S New Ballas Rd
Ste 2015
Saint Louis, MO 63141
Phone (314) 251-1775

901 Patients First Dr
#2500
Washington, MO 63090

Organizations & group practices 5

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 4

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1811301740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-692-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-692-2807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S Kirkwood Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631227250",
            "country_code": "US",
            "telephone_number": "314-692-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10012 Kennerly Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282197",
            "country_code": "US",
            "telephone_number": "314-692-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4280 Mid America Ln Ste 10",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631291202",
            "country_code": "US",
            "telephone_number": "636-692-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10004 Kennerly Rd Ste 115A",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631285106",
            "country_code": "US",
            "telephone_number": "314-692-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12200 Weber Hill Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631271569",
            "country_code": "US",
            "telephone_number": "314-692-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7345 Watson Rd # Ll1",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631199804",
            "country_code": "US",
            "telephone_number": "314-692-2807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAHANDA",
        "first_name": "MILAN",
        "middle_name": "GIMANTHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2022015523",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MO",
            "license": "2022015523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Graham Rd Ste C-2310",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.