Active NPI
Metro Cardiology Group LTD
- Cardiovascular Disease Physician
- Belleville, IL
National Provider Identifier
1891729497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- METRO CARDIOLOGY GROUP LTD
- Practice address
- 4600 Memorial Dr Ste 420
Belleville, IL 62226-5366 - Phone
- (618) 239-3356
- Fax
- (618) 239-3359
- NPI assigned
- Jul 10, 2006
- Last updated
- Jun 22, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanullah Khan Pathan, MD
- Title
- President
- Phone
- (618) 239-3356
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
4600 Memorial Dr Ste 420
Belleville, IL 62226-5366
Mailing address
4600 Memorial Dr
Medical Center 2 Ste 420
Belleville, IL 62226-5366
Phone (618) 239-3356
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08200472 | Other | IL | BCBS |
| 2507179 | Other | UHC | |
| 146897XX | Other | PREFERRED CARE | |
| D14712 | Other | MERCY HEALTH PLAN | |
| 036060909 | Medicaid | IL | |
| 0938287001 | Other | CIGNA | |
| 100789 | Other | MO | BCBS |
| 7661 | Other | GHP CMR | |
| 101463 | Other | HEALTHLINK | |
| CA5095 | Other | IL | RR MEDICARE |
| 2102754 | Other | AETNA | |
| 140491 | Other | PHCS | |
| 1495152 | Other | PA | BCBS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Cardiovascular Disease Physician
- Belleveille, IL
- NPI 1093749699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1277164800000",
"number": "1891729497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 MEMORIAL DR",
"address_2": "MEDICAL CENTER 2 STE 420",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265366",
"telephone_number": "618-239-3356",
"fax_number": "618-239-3359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 MEMORIAL DR STE 420",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265366",
"telephone_number": "618-239-3356",
"fax_number": "618-239-3359"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "METRO CARDIOLOGY GROUP LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2010-06-22",
"status": "A",
"authorized_official_last_name": "PATHAN",
"authorized_official_first_name": "AMANULLAH",
"authorized_official_middle_name": "KHAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "618-239-3356",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "08200472",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "2507179",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "146897XX",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY HEALTH PLAN",
"identifier": "D14712",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036060909",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0938287001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "100789",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP CMR",
"identifier": "7661",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "101463",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CA5095",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2102754",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "140491",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1495152",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.