Active NPI
Surendra Shenoy, MD
- Transplant Surgery Physician
- Saint Louis, MO
National Provider Identifier
1972521490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Transplant Surgery Physician
- License
- 106430
- Practice address
- 4921 Parkview PL
Div Surg Transplant, Ste 12B
Saint Louis, MO 63110-1032 - Phone
- (314) 747-9889
- Fax
- (314) 361-4197
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 106430 | MO | |
| Transplant Surgery Physician | 204F00000X | 106430 | MO | Primary |
Addresses
Primary practice location
4921 Parkview PL
Div Surg Transplant, Ste 12B
Saint Louis, MO 63110-1032
Mailing address
PO Box 60352
Saint Louis, MO 63160-0352
Phone (314) 747-9889
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207975004 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 84.2 of 100
- Quality
- 71.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106430 | MO | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- sshenoy161486@direct.carenet.org
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1972521490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60352",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631600352",
"telephone_number": "314-747-9889",
"fax_number": "314-361-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4921 PARKVIEW PL",
"address_2": "DIV SURG TRANSPLANT, STE 12B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101032",
"telephone_number": "314-747-9889",
"fax_number": "314-361-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENOY",
"first_name": "SURENDRA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MO",
"license": "106430",
"primary": false
},
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "MO",
"license": "106430",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207975004",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "4921 Parkview Pl",
"address_2": "Div Surg Transplant, Ste 12B",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101032",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.