Individual provider Active NPI

Edina Karahodzic, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1891895934
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003012646 Issued in MO
Practice address
12348 Old Tesson Rd Ste 240
Saint Louis, MO 63128-2251
Phone
(314) 467-3900
Fax
(314) 467-3919
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2003012646 MO Primary

Addresses

Primary practice location

12348 Old Tesson Rd Ste 240
Saint Louis, MO 63128-2251

Mailing address

3915 Watson Rd Ste 203
Saint Louis, MO 63109
Phone (314) 644-4410

Other identifiers 2

IdentifierTypeStateIssuer
P00170065OtherRAILROAD MEDICARE
209075308MedicaidMO

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
I20080625000107 MO Practitioner - Family Practice 4284705898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

12348 Old Tesson Rd
Suite 240
Saint Louis, MO 63128-2251
Phone (314) 467-3900

Hospital & facility affiliations

  • Amedisys Home Health of Missouri Home health agency, Hillsboro, MO, CCN 267270
  • Mercy Home Health Home health agency, Saint Louis, MO, CCN 267253
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003012646MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Dec 11, 2023 Accepting new patients

Locations

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

3915 Watson Rd
Ste 203
Saint Louis, MO 63109
Phone (314) 644-4410

12348 Old Tesson Rd
Ste 240
Saint Louis, MO 63128
Phone 3144673900 ext. 284

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1891895934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 WATSON RD STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63109",
            "telephone_number": "314-644-4410",
            "fax_number": "314-646-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12348 OLD TESSON RD STE 240",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282251",
            "telephone_number": "314-467-3900",
            "fax_number": "314-467-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARAHODZIC",
        "first_name": "EDINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003012646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00170065",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209075308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.