NPIMap

Individual provider Active NPI

Geetha Balasubramanian, MD

  • Nephrology Physician
  • Lake St Louis, MO
National Provider Identifier
1942219563
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2008019340 Issued in MO
Practice address
1000 Edgewater PT Ste 303
Lake St Louis, MO 63367-2954
Phone
(636) 265-2225
Fax
(636) 265-0320
NPI assigned
Aug 5, 2006
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 2008019340 MO Primary

Addresses

Primary practice location

1000 Edgewater PT Ste 303
Lake St Louis, MO 63367-2954

Mailing address

1000 Edgewater PT Ste 303
Lake St Louis, MO 63367-2954
Phone (636) 265-2225

Other practice location 1

3394 McKelvey Rd Ste 115
Bridgeton, MO 63044-2531
Phone (636) 265-2225

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
I20090914000054 MO Practitioner - Nephrology 8921044389 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1000 Edgewater PT
Suite 303
Lake St Louis, MO 63367-2954
Phone (636) 265-2225

3394 McKelvey Rd
Suite 115
Bridgeton, MO 63044-2531
Phone (636) 265-2225

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arch Kidney and Hypertension LLC Nephrology CurrentSince Dec 18, 2013 Accepting new patients
Amin Nephrology and Hypertension Specialists, Inc Nephrology PastSince Sep 1, 2006 Accepting new patients

Locations

3394 McKelvey Rd
Ste 115
Bridgeton, MO 63044
Phone (314) 643-7692

2 Harbor Bend Ct
Ste 227
Lake St Louis, MO 63367
Phone (636) 265-2225

3009 N Ballas Rd
Ste 142A
Saint Louis, MO 63131
Phone (314) 993-4949

Interoperability endpoints

  • Direct secure messaging: geetha.balasubramanian@direct.davitaphysiciansolutions.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DEFGAA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1942219563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EDGEWATER PT STE 303",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672954",
            "telephone_number": "636-265-2225",
            "fax_number": "636-265-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EDGEWATER PT STE 303",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672954",
            "telephone_number": "636-265-2225",
            "fax_number": "636-265-0320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3394 McKelvey Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442531",
            "country_code": "US",
            "telephone_number": "636-265-2225",
            "fax_number": "636-265-0320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALASUBRAMANIAN",
        "first_name": "GEETHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2008019340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.