NPIMap

Individual provider Active NPI

Bassem Mikhail, MD

  • Interventional Cardiology Physician
  • Hannibal, MO
National Provider Identifier
1932189735
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2003011832 Issued in MO
Practice address
100 Medical Dr
Hannibal, MO 63401-6877
Phone
(573) 231-3228
Fax
(573) 231-3758
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 2003011832 MO Primary

Addresses

Primary practice location

100 Medical Dr
Hannibal, MO 63401-6877

Mailing address

100 Medical Dr
PO Box 311
Hannibal, MO 63401-6877
Phone (573) 231-3228

Other identifiers 1

IdentifierTypeStateIssuer
209100114MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000712 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2567360019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Saint Louis, MO 63128-2197

1390 US Hwy 61
Suite N1500
Festus, MO 63028-4137
Phone (314) 251-1700

434 N W St
Mercy Clinic Cardiology Perryville
Perryville, MO 63775-1359
Phone (636) 933-5055

509 W Pine St B
Mercy Clinic Cardiology Farmington
Farmington, MO 63640-1439
Phone (636) 933-5055

625 S New Ballas Rd
Saint Louis, MO 63141-8253

901 Patients 1St Dr
Suite 2500
Washington, MO 63090-4700
Phone (314) 251-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11
Pacemaker insertion or repair17
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Jan 1, 2016 Accepting new patients
Mercy Hospital South Past Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients
Cardiology & Critical Care Consultants Inc Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

6420 Clayton Rd
#303
Saint Louis, MO 63117

8820 Manchester Rd
Saint Louis, MO 63144
Phone (314) 963-8100

Interoperability endpoints

  • Direct secure messaging: bmikhail761066@directc.mercy.net

Organizations & group practices 5

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 7

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1932189735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "address_2": "PO BOX 311",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3228",
            "fax_number": "573-231-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3228",
            "fax_number": "573-231-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "BASSEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2003011832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209100114",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.