Individual provider Active NPI

Surendra Shenoy, MD

  • Transplant Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1972521490
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
106430 Issued in MO
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

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
207975004MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
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 Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
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

LicenseStateTypeSpecialty
106430MOMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.