Individual provider Active NPI

Mahmood Qalbani, MD

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1851462063
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036063618 Issued in IL
Practice address
1755 S Grand Blvd
Saint Louis, MO 63104-1540
Phone
(314) 256-3850
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036063618 IL Primary

Addresses

Primary practice location

1755 S Grand Blvd
Saint Louis, MO 63104-1540

Mailing address

1836 Lackland Hill Pkwy
Credentialing Department
Saint Louis, MO 63146-3572
Phone (314) 989-0300

Other identifiers 1

IdentifierTypeStateIssuer
036063618001MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mqalbani19443@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
I20100630000333 MO Practitioner - Anesthesiology 7618887423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

3241 Percy Dr
Cape Girardeau, MO 63701-4901
Phone (573) 334-1222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036063618ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aim Anesthesia LLC Anesthesiology CurrentSince Apr 30, 2017 Accepting new patients
G & G Anesthesia LLC CurrentSince Apr 12, 2023 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

3550 McKelvey Rd
Bridgeton, MO 63044
Phone 31474109114048

3241 Percy Dr
Cpe Girardeau, MO 63701
Phone (573) 334-1222

4801 Weldon Spring Pkwy
Weldon Spring, MO 63304
Phone (636) 441-7300

Interoperability endpoints

  • Direct secure messaging: mqalbani19443@direct-ehr-ssmhc.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1851462063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041540",
            "telephone_number": "314-256-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QALBANI",
        "first_name": "MAHMOOD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036063618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036063618001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mqalbani19443@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mqalbani19443@direct-ehr-ssmhc.com",
            "address_1": "1755 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041540",
            "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": "1755 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041540",
            "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.