DR. GAUTAM VANGIPURAM (NPI# 1780052233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780052233 |
| Entity Type | Individual |
| Full Name | DR. GAUTAM VANGIPURAM |
| Credential | M.D |
| Practice Address |
17 The Boulevard Saint Louis Saint Louis MO 63117-1118 |
| Mailing Address |
1600 S Brentwood Blvd Ste 800 Saint Louis MO 63144-1317 |
| Practice Telephone | 3143671181 |
| Practice Fax Number | 3149685117 |
| Mailing Telephone | 3143671181 |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2019-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 2019018140 | MO | Allopathic & Osteopathic Physicians |
| N | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
2019018140 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
17 THE BOULEVARD SAINT LOUIS |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476560 | Kevin J Blinder | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-06-08 |
| 1033505086 | Alexander R Bottini | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2015-04-07 |
| 1629496849 | Waseem Ansari | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2014-04-03 |
| 1205179496 | Himanshu Kumar Banda | Student in an Organized Health Care Education/Training Program | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2013-04-05 |
| 1841558822 | Alia Durrani | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117 | 2012-04-27 |
| 1700175395 | Retina Consultants, Ltd | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2011-04-04 |
| 1740579531 | Sabin Dang | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2011-03-31 |
| 1588608970 | Bradley Thomas Smith | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2006-06-15 |
| 1205837978 | Thomas K Krummenacher | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-03 |
| 1508867318 | Richard Joseph Rothman | Ophthalmology | 17 The Boulevard Saint Louis, Saint Louis, MO 63117-1118 | 2005-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790265759 | Washington University | Ophthalmology | 4901 Forest Park Ave # 8221, Saint Louis, MO 63108-1495 | 2018-08-20 |
| 1184038986 | Grace L Paley | Ophthalmology | 621 S New Ballas Rd Ste 5006b, Saint Louis, MO 63141-8270 | 2014-06-19 |
| 1992140958 | Andrew Robert Lee | Ophthalmology | 660 S Euclid Ave # 8096, Saint Louis, MO 63110-1010 | 2013-05-03 |
| 1083941488 | William Steven Joffe | Ophthalmology | 4912 Mcpherson Ave, Saint Louis, MO 63108-1608 | 2009-11-06 |
| 1033349741 | Nancy Buchser | Ophthalmology | 4921 Parkview Pl Ste 14f, Saint Louis, MO 63110-1032 | 2009-07-16 |
| 1730316449 | Augustine Richard Hong | Ophthalmology | 5201 Mid America Plz Ste 2500, Ste 2500, Saint Louis, MO 63129-0002 | 2009-06-20 |
| 1548470032 | Fe Poblete Fuentes | Ophthalmology | 84 Grasso Plz, Saint Louis, MO 63123-3108 | 2007-05-23 |
| 1255543047 | Malaz Safi, M.d., P.C. | Ophthalmology | 8790 Watson Rd Ste 203, Saint Louis, MO 63119-5140 | 2007-05-04 |
| 1063535623 | Therese M Alban | Ophthalmology | 12395 Olive Blvd, Suite 301, Saint Louis, MO 63141-5462 | 2007-04-09 |
| 1902924368 | Eye Specialists of West County, P.C. | Ophthalmology | 777 S New Ballas Rd Ste 218e, Saint Louis, MO 63141-8718 | 2007-03-26 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.