NPIMap

Individual provider Active NPI

Haseena Mazhar Ali, MD

  • Internal Medicine Physician
  • Saint Charles, MO
National Provider Identifier
1851738769
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2020004473 Issued in MO
Practice address
711 Veterans Memorial Pkwy Ste 300
Saint Charles, MO 63303-2106
Phone
(636) 669-2350
NPI assigned
May 31, 2013
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MTL001477 DC
Internal Medicine Physician 207R00000X 2020004473 MO Primary

Addresses

Primary practice location

711 Veterans Memorial Pkwy Ste 300
Saint Charles, MO 63303-2106

Mailing address

PO Box 955534
Saint Louis, MO 63195-2106

Other practice location 1

2041 Georgia Ave NW
Washington, DC 20060-0001
Phone (202) 865-4224

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address hali371573@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200322000135 MO Practitioner - Internal Medicine 4587942735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

711 Veterans Memorial Pkwy
Suite 300
Saint Charles, MO 63303-2106
Phone (636) 669-2350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020004473MOMDInternal Medicine Physician
MTL001477DCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Feb 11, 2020 Accepting new patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Feb 11, 2020 Accepting new patients
SSM Depaul Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

711 Veterans Memorial Pkwy
Ste 300
Saint Charles, MO 63303
Phone (636) 669-2215

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: hali371573@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1851738769",
    "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": "631952106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 VETERANS MEMORIAL PKWY STE 300",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633032106",
            "telephone_number": "636-669-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200600001",
            "country_code": "US",
            "telephone_number": "202-865-4224",
            "fax_number": "202-865-7199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "HASEENA MAZHAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": "MTL001477",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2020004473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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": "711 Veterans Memorial Pkwy Ste 300",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633032106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hali371573@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hali371573@direct-ehr-ssmhc.com",
            "address_1": "711 Veterans Memorial Pkwy Ste 300",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633032106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.