DR. NISHA MANGALAT (NPI# 1992970792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992970792 |
| Entity Type | Individual |
| Full Name | DR. NISHA MANGALAT |
| Credential | M.D. |
| Practice Address |
1465 S Grand Blvd Saint Louis MO 63104-1003 |
| Practice Telephone | 3142684010 |
| Practice Fax Number | 3142682775 |
| Mailing Telephone | 3142684010 |
| Mailing Fax Number | 3142682775 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2019-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 2008002908 | MO | Allopathic & Osteopathic Physicians |
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
2012012182 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1465 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676921 | Gunjanpreet Kaur | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-07-21 |
| 1972128510 | Millicent Rose Palacios | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-06-09 |
| 1083241863 | Nathaniel Joseph Conner | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1467089177 | Stacy Kollanur Mathews | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1568099299 | Susan Aye Mya Oo | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1861029514 | Gregory Joseph Weissler II | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1154958874 | Brendan Michael Mcenery | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1316574049 | Satvika Mikkilineni | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1972130607 | Katherine Letha Randolph | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
| 1346877081 | Samuel Ryan Richey | Student in an Organized Health Care Education/Training Program | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2020-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
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| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487781597 | Tessa Gardner | Pediatrics | 7905 Blackberry Ave, Saint Louis, MO 63130-2710 | 2007-02-27 |
| 1295885580 | Edwin Lemuel Anderson | Pediatrics | 1100 S Grand Blvd Fl 1, Saint Louis, MO 63104-1015 | 2007-01-11 |
| 1518274489 | Mercy Clinic Children's Infectious Disease, LLC | Pediatrics | 621 S New Ballas Rd, Suite 674-a, Saint Louis, MO 63141-8232 | 2010-09-13 |
| 1427277110 | St Louis University | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-24 |
| 1285656322 | Russell J Osguthorpe | Pediatrics | 1 Childrens Pl, Suite C, Saint Louis, MO 63110-1002 | 2006-07-25 |
| 1730106238 | Patrick C Seed | Pediatrics | 1 Childrens Pl, Suite C, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1417933433 | Anita Chacko | Pediatrics | 621 S New Ballas Rd, Ste. 674a, Saint Louis, MO 63141-8232 | 2005-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184936437 | Liset Carla Olarte Carhuaz | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2010-07-01 |
| 1083849871 | Christelle Marlyse Ilboudo | Pediatrics | 404 N Keene St, Columbia, MO 65201-6626 | 2009-05-21 |
| 1922249739 | Barbara Angelica Pahud | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2009-03-09 |
| 1457507832 | Jennifer Schuster | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-08-17 |
| 1013172055 | Rana El Feghaly | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-07-18 |
| 1790736510 | Christopher Joseph Harrison | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-15 |
| 1366493728 | Angela Leigh Myers | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1710938188 | Mary Anne Jackson | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1326099714 | Douglas Scott Swanson | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1154371615 | Denise Bratcher | Pediatrics | 2401 Gillham Rd, Children's Mercy Hospital and Clinics, Kansas City, MO 64108-4619 | 2006-05-12 |
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| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.