Individual provider Active NPI

Muhammad A. Nyazee, MD

  • Gastroenterology Physician
  • Saint Louis, MO
National Provider Identifier
1952494932
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R3C90 Issued in MO
Practice address
11155 Dunn Rd Ste 212E
Saint Louis, MO 63136-6166
Phone
(314) 837-4200
Fax
(314) 972-0402
NPI assigned
Oct 2, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X R3C90 MO Primary

Addresses

Primary practice location

11155 Dunn Rd Ste 212E
Saint Louis, MO 63136-6166

Mailing address

6 Jungermann Cir Ste 215
Saint Peters, MO 63376-1626
Phone (636) 928-1231

Other identifiers 1

IdentifierTypeStateIssuer
201736105MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE) Christian Hospital Northeast- Northwest

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100111000243 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 6608916580
I20100812001054 MO Practitioner - Internal MedicinePractitioner - Gastroenterology 6608916580

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3C90MOMDGastroenterology Physician

Interoperability endpoints

  • Direct secure messaging: mnyazee@yourcarecommunity.org
  • Direct secure messaging: mnyazee154737@direct.carenet.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1952494932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 JUNGERMANN CIR STE 215",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761626",
            "telephone_number": "636-928-1231",
            "fax_number": "636-922-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 DUNN RD STE 212E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366166",
            "telephone_number": "314-837-4200",
            "fax_number": "314-972-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAZEE",
        "first_name": "MUHAMMAD",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "R3C90",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201736105",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Christian Hospital Northeast- Northwest",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11155 Dunn Rd Ste 212E",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.