Active NPI
Sunil Gangwani, M.D.
- Psychiatry Physician
- Chesterfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2017030250
- Practice address
- 1176 Town and Country Commons Dr
Chesterfield, MO 63017-8200 - Phone
- (314) 251-2870
- Fax
- (314) 251-2871
- NPI assigned
- Jul 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2007012480 | MO | |
| Psychiatry Physician | 2084P0800X | 036-126918 | IL | |
| Psychiatry Physician | 2084P0800X | 2017030250 | MO | Primary |
Addresses
Primary practice location
1176 Town and Country Commons Dr
Chesterfield, MO 63017-8200
Mailing address
1176 Town and Country Commons Dr
Chesterfield, MO 63017-8200
Phone (314) 251-2870
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12125 Conway Rd
Suite 160
Saint Louis, MO 63141-8241
Phone (314) 251-2870
Hospital & facility affiliations
- Mercy Hospital St Louis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-126918 | IL | MD | Psychiatry Physician |
| 2007012480 | MO | MD | Psychiatry Physician |
| 2017030250 | MO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital Perry | Current | Accepting new patients | |
| Mercy Clinic Adult Psychiatry, LLC | Psychiatry | Current | Accepting new patients |
| Mercy Hospital Perry | Current | Accepting new patients |
Locations
434 N West St
Perryville, MO 63775
Phone (573) 547-2530
212 Hospital Ln
Ste 205
Perryville, MO 63775
Phone (573) 547-3116
12125 Conway Rd
Ste 160
Saint Louis, MO 63141
Phone (314) 251-2870
1176 Town and Country Commons Dr
Town and Country, MO 63017
Phone (636) 207-2200
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.
-
- Psychiatry Physician
- Festus, MO
- NPI 1750788972
-
- Critical Access Hospital
- Perryville, MO
- NPI 1063117158
-
- Rural Health Clinic/Center
- Perryville, MO
- NPI 1639858855
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1902004203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1176 TOWN AND COUNTRY COMMONS DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630178200",
"telephone_number": "314-251-2870",
"fax_number": "314-251-2871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1176 TOWN AND COUNTRY COMMONS DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630178200",
"telephone_number": "314-251-2870",
"fax_number": "314-251-2871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANGWANI",
"first_name": "SUNIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-07",
"last_updated": "2023-04-04",
"certification_date": "2021-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2007012480",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036-126918",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2017030250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chesterfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.