Active NPI
Ilijas Gusmirovic, D.O.
- Anesthesiology Physician
- Maryville, IL
National Provider Identifier
1861624975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036135225
- Practice address
- 6800 State Route 162
Maryville, IL 62062-8500 - Phone
- (314) 577-8000
- NPI assigned
- Aug 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2016031224 | MO | |
| Anesthesiology Physician | 207L00000X | 036135225 | IL | Primary |
Addresses
Primary practice location
6800 State Route 162
Maryville, IL 62062-8500
Mailing address
6800 State Route 162
Maryville, IL 62062-8500
Phone (314) 616-5799
Other practice location 1
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | MISSOURI BAPTIST MEDICAL CENTER |
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
- Anesthesiology
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7311
11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5000
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000
Hospital & facility affiliations
- Christian Hospital Northeast
- Barnes-Jewish St Peters Hospital
- Missouri Baptist Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri Baptist Medical Center | Anesthesiology | Current | Accepting new patients |
| SSM Health Slu Hospital Anesthesia Physician Billing, LLC | Anesthesiology | Current | Accepting new patients |
Locations
3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
Interoperability endpoints
- igusmirovic28823@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.
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1609658905
-
- Anesthesiology Physician
- Saint Louis, MO
- NPI 1407232804
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Peters, MO
- NPI 1144238908
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1639186760
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1487663506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734912000000",
"number": "1861624975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 STATE ROUTE 162",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628500",
"telephone_number": "314-616-5799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 STATE ROUTE 162",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620628500",
"telephone_number": "314-577-8000"
}
],
"practiceLocations": [
{
"address_1": "3015 N Ballas Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631312329",
"country_code": "US",
"telephone_number": "314-996-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUSMIROVIC",
"first_name": "ILIJAS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-23",
"last_updated": "2024-12-23",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "2016031224",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036135225",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"endpointDescription": "BJC",
"affiliationName": "MISSOURI BAPTIST MEDICAL CENTER",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3015 N Ballas Rd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312329",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.