Active NPI
Shady Hawatmeh
- Internal Medicine Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2017022834
- Practice address
- 621 S New Ballas Rd Ste 112a
Saint Louis, MO 63141-8252 - Phone
- (314) 251-6339
- NPI assigned
- Feb 2, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2017022834 | MO | Primary |
Addresses
Primary practice location
621 S New Ballas Rd Ste 112a
Saint Louis, MO 63141-8252
Mailing address
9429 Caddyshack Cir
Saint Louis, MO 63127-1937
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
- Internal Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339
Hospital & facility affiliations
- Mercy Hospital St Louis
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Adult Hospitalists - St. Louis, LLC | Internal Medicine | Current | Accepting new patients |
| Mercy Clinic Adult Hospitalists - Washington, LLC | Current | Accepting new patients | |
| St Anthonys Physician Organization Hospitalist Services, L.C. | Current | Accepting new patients | |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Mercy Hospital Lincoln | Internal Medicine | Current | Accepting new patients |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Mercy Clinic Adult Hospitalists- Jefferson, LLC | Internal Medicine | Current | Accepting new patients |
| Mercy Hospitals East Communities | Internal Medicine | Past | Accepting new patients |
Locations
1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111
621 S New Ballas Rd
Ste 3016B
Saint Louis, MO 63141
Phone (314) 251-6339
621 S New Ballas Rd
Ste 112A
Saint Louis, MO 63141
Phone (314) 251-6339
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585
901 E 5th St
Washington, MO 63090
Phone (636) 239-8000
Organizations & group practices 8
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1841235108
-
- Clinic/Center
- Saint Louis, MO
- NPI 1851431738
-
- Hospitalist Physician
- Washington, MO
- NPI 1891943429
-
- Internal Medicine Physician
- Festus, MO
- NPI 1083052492
-
- Hospitalist Physician
- Saint Louis, MO
- NPI 1407216336
-
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
Internal Medicine
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": "1422835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1922498617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9429 CADDYSHACK CIR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631271937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS RD STE 112A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418252",
"telephone_number": "314-251-6339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWATMEH",
"first_name": "SHADY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-02",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2017022834",
"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 Apr 4, 2019; 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.