Dr Gautam Datta, MD in Saint Louis, MO

Dr Gautam Datta, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Saint Louis, Missouri. He graduated from medical school in 2002 and has 23 years of diverse experience with area of expertise as Psychiatry. He is a member of the group practice Ahs Il Medical Group Llc and his current practice location is 763 S New Ballas Rd, Suite 110, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at (314) 843-4333.

Dr Gautam Datta is licensed to practice in Missouri (license number 2007008850) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1568688414.

Contact Information

	Dr Gautam Datta, MD
	763 S New Ballas Rd, Suite 110, Saint Louis, MO 63141-8704
	(314) 843-4333
	(314) 843-4856

Map and Direction

Physician's Profile

Full Name	Dr Gautam Datta
Gender	Male
Speciality	Psychiatry
Experience	23 Years
Location	763 S New Ballas Rd, Saint Louis, Missouri
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Gautam Datta graduated from medical school in 2002

NPI Data:

NPI Number: 1568688414
Provider Enumeration Date: 04/18/2007
Last Update Date: 10/03/2012

Medicare PECOS Information:

PECOS PAC ID: 6406957851
Enrollment ID: I20160901000093

Medical Identifiers

Medical identifiers for Dr Gautam Datta such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568688414	NPI	-	NPPES
209908706	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084P0800X	Psychiatry & Neurology - Psychiatry	35087615 (Ohio)	Secondary
2084P0800X	Psychiatry & Neurology - Psychiatry	2007008850 (Missouri)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Gateway Regional Medical Center	Granite city, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ahs Il Medical Group Llc	5496111676	51

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Gautam Datta allows following entities to bill medicare on his behalf.

Entity Name	Ahs Il Medical Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659098101 PECOS PAC ID: 5496111676 Enrollment ID: O20230512001300

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Gautam Datta is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Gautam Datta, MD 5000 Cedar Plaza Pkwy, Suite 350, Saint Louis, MO 63128-3854 Ph: (314) 843-4333	Dr Gautam Datta, MD 763 S New Ballas Rd, Suite 110, Saint Louis, MO 63141-8704 Ph: (314) 843-4333

Reviews and Comments

Psychiatry & Neurology Doctors in Saint Louis, MO

Dr. Lauren Flynn, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 231 W Lockwood Ave, Suite 202, Saint Louis, MO 63119 Phone: 314-737-4070
Hannah Edelman, MD, PHD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Pl, Saint Louis, MO 63110 Phone: 314-454-6120
Dr. Antonina S Gesmundo, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1 Jefferson Barracks Dr, Saint Louis, MO 63125 Phone: 314-894-6636
Mr. Robert Harry Brady, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1430 Olive St, Suite 500, Saint Louis, MO 63103 Phone: 314-206-3724 Fax: 314-206-3708
Dr. Marcus E Raichle, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 517 S Euclid Ave, Ground Floor, Saint Louis, MO 63110 Phone: 314-362-6907 Fax: 314-747-3258
Rohit Pawar, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 10018 Kennerly Rd, Saint Louis, MO 63128 Phone: 314-525-7275 Fax: 314-525-7260
Dr. Rushaniya Albeptovna Khairova, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 24 S Kingshighway Blvd, Saint Louis, MO 63108 Phone: 314-286-1700 Fax: 314-286-1730

Dr Gautam Datta, MD - Medicare Psychiatry in Saint Louis, MO