HUMBERTO M FAGUNDES (NPI# 1033227806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033227806 |
| Entity Type | Individual |
| Full Name | HUMBERTO M FAGUNDES |
| Credential | MD |
| Practice Address |
3015 N New Ballas Rd St Louis MO 63131 |
| Mailing Address |
55 W Port Plz Suite 300 Saint Louis MO 63146-3109 |
| Practice Telephone | 3149965180 |
| Practice Fax Number | 3148212180 |
| Mailing Telephone | 3145484772 |
| Mailing Fax Number | 3145484748 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2012-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
100121 | MO | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
100121 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO LICENSE | 100121 | 01 | |
| DEA | BF3076127 | 01 | |
| RRMEDICARE | 920004686 | 01 | |
| MCAID | 207947516 | 01 | |
| BNDD | 32286 | 01 | |
| CPIN | 33012444 | 01 |
| Street Address |
3015 N NEW BALLAS RD |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245257922 | Amy A Mosher | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-07-17 |
| 1942383914 | Walter G Holloman Jr. | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-10-23 |
| 1811008444 | William W Baber | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-31 |
| 1508974379 | Douglas J Curry | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-29 |
| 1679680821 | Steven L Solomon | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-24 |
| 1093829970 | Christopher O Thornton | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-18 |
| 1083621155 | John H Niemeyer | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-02 |
| 1629082284 | Linda Proctor | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-07-28 |
| 1447264007 | Gene L Davis Jr. | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-07-28 |
| 1265446827 | Geoffrey S Hamill | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097954 | Avalcare Inc | Pharmacy | 10431 Clayton Rd, Saint Louis, MO 63131 | 2020-03-06 |
| 1891331369 | Life Clinic of Mo Dc PC | Chiropractor | 2051 South Lindbergh Blvd, Frontenac, MO 63131 | 2019-11-20 |
| 1447892542 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 30 S Lindbergh Blvd, Saint Louis, MO 63131 | 2019-10-10 |
| 1336797026 | Justa Davis | Dietitian, Registered | 3015 North Ballas, Saint Louis, MO 63131 | 2019-08-27 |
| 1730695362 | Curators of The University of Missouri | Psychologist | 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 | 2017-12-19 |
| 1770012031 | Danielle Marie Hargate | Specialist/Technologist | 732 Timber Trail, Frontenac, MO 63131 | 2017-06-08 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1437524360 | Julie Ann Godefroid | Nurse Practitioner | 1010 Old Des Peres Road, St. Louis, MO 63131 | 2015-12-03 |
| 1073982435 | Rebecca Baum Rainbolt | Social Worker | 12210 Clayton Rd, Saint Louis, MO 63131 | 2015-09-16 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| Find all providers in zip 63131 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073838322 | Jenny Lynne Shaffer | Radiology | 10010 Kennerly Road, Attn Cancer Care Center, St Louis, MO 63128-2106 | 2010-03-30 |
| 1316967722 | Macdonald B Logie | Radiology | 3635 Vista, St Louis, MO 63110 | 2006-07-20 |
| 1063439677 | Bruce J Walz | Radiology | 3635 Vista, St Louis, MO 63110 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778228 | Central Care, Pa | Radiology | 1004 Carondelet Dr Ste 410, Kansas City, MO 64114-4801 | 2020-10-23 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1568721454 | Jason Matthew Edwards | Radiology | 232 S Woods Mill Rd Ste 110e, Chesterfield, MO 63017 | 2012-05-11 |
| 1649569385 | Sagar Chandravadan Patel | Radiology | 211 Saint Francis Dr Ste 372, Cape Girardeau, MO 63703-5049 | 2011-04-04 |
| 1922326958 | Yvonne Thanh-nga D Pham | Radiology | 6601 Winchester Ave Ste 230, Kansas City, MO 64133-4681 | 2010-05-14 |
| 1811158587 | Benjamin Bin Yan | Radiology | 1111 Kentucky Ave., Omc Cancer Treatment Center, West Plains, MO 65775-2028 | 2008-06-24 |
| 1336338912 | Joseph Fields | Radiology | 9 Heather Hill Ln, Saint Louis, MO 63132-4105 | 2007-10-18 |
| 1205033941 | Associates In Tumor Therapy, Chartered | Radiology | 2801 Clearwater Ct, Joplin, MO 64801-8239 | 2007-06-27 |
| 1700916848 | Bethesda Resources Inc | Radiology | 1124 N Main St, Sikeston, MO 63801-5046 | 2007-03-07 |
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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.