Active NPI
Ladan Fazlollahi, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 2011016187
- Practice address
- 660 S Euclid Ave
Saint Louis, MO 63110-1010 - Phone
- (314) 362-7440
- NPI assigned
- Jul 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 2011016187 | MO | Primary |
Addresses
Primary practice location
660 S Euclid Ave
Saint Louis, MO 63110-1010
Mailing address
660 S Euclid Ave
Saint Louis, MO 63110-1010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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
- Pathology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 85.32
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011016187 | MO | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University at Palisades Medical Center | Anatomic Pathology & Clinical Pathology | Past | Accepting new patients |
Locations
630 W 168th St
New York, NY 10032
Phone (212) 305-1948
630 W 168th St
#23
New York, NY 10032
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
Ph 1564
New York, NY 10032
Phone (212) 305-7399
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 4
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.
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Anatomic Pathology & Clinical Pathology
-
- Internal Medicine Physician
- New York, NY
- NPI 1861907321
-
- Pediatric Pathology Physician
- North Bergen, NJ
- NPI 1437259322
Anatomic Pathology & Clinical Pathology
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cortlandt Manor, NY
- NPI 1881659274
-
- General Acute Care Hospital
- New York, NY
- NPI 1144504044
-
- General Acute Care Hospital
- New York, NY
- NPI 1194832477
-
- General Acute Care Hospital
- Bronxville, NY
- NPI 1780196345
-
- General Acute Care Hospital
- New York, NY
- NPI 1952332801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1922386838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-7440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZLOLLAHI",
"first_name": "LADAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-26",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MO",
"license": "2011016187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.