Individual provider Active NPI

Anjum Razzaque, M.D.

  • Emergency Medicine Physician
  • O'Fallon, MO
National Provider Identifier
1962427229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R7P08 Issued in MO
Practice address
2630 Highway K
O Fallon, MO 63368-6624
Phone
(636) 980-5300
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R7P08 MO Primary

Addresses

Primary practice location

2630 Highway K
O Fallon, MO 63368-6624

Mailing address

20 Clayton Ter
Saint Louis, MO 63131-2918
Phone (314) 989-0833

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080206000142 MO Practitioner - Internal Medicine 5496838047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6542 Manchester Ave
Saint Louis, MO 63139-3520
Phone (314) 647-0081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7P08MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Kansas PA CurrentSince Jan 1, 2016 Accepting new patients
American Current Care of Kansas PA Current Accepting new patients
American Current Care of Kansas PA CurrentSince Jan 1, 2016 Accepting new patients
Physician Groups LC Past Accepting new patients

Locations

6401 E Front St
Kansas City, MO 64120
Phone (816) 241-0603

83 Progress Pkwy
Maryland Hts, MO 63043
Phone (314) 434-8174

5506 Corporate Dr
Ste 1700
Saint Joseph, MO 64507
Phone (816) 671-4880

6542 Manchester Ave
Saint Louis, MO 63139
Phone (314) 647-0081

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962427229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CLAYTON TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312918",
            "telephone_number": "314-989-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-980-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZZAQUE",
        "first_name": "ANJUM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R7P08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.