Shyam S Ivaturi, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

2001006095 Issued in MO

Practice address

12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287

Phone

(314) 892-6565

Fax

(314) 892-4828

NPI assigned

Oct 12, 2005

Last updated

Apr 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Pulmonology - St. Louis, LLCGroup PAC ID 2365599925, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mercy Clinic Pulmonology - St. Louis, LLC

  • Pulmonary Disease Physician
  • Saint Louis, MO
  • NPI 1821137886
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Adult Critical Care, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1730119421
  Medicare reassignment
• Midwest Pulmonary and Critical Care Consultants Inc

  • Pulmonary Disease Physician
  • Saint Louis, MO
  • NPI 1023138369
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  dba Mercy Hospital St Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  dba Mercy St. Louis Transport Ambulance

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1881682904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283287",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283287",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVATURI",
        "first_name": "SHYAM",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2001006095",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2001006095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205374135",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malak Itani, MD
• Kendall A Itoku, MD
• Andrea Diane Itzkowitz, M.D.
• Milos Ivanovic, MD
• Pranati Ivaturi, M.D.
• Renee A Ivens, PT
• Jessica Iver, ATC, LAT
• Whittney Renae Iver, FNP
• Jennifer J Iverson, ED.S., LPC, RPT
• Kimberly Susan Iverson, MT-BC

• Pulmonary Disease Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pulmonary Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.

Verify at the official NPI Registry.