1. Home
  2. Directory
  3. Missouri
  4. Saint Louis
  5. Internal Medicine
  6. NPI Profile

OMAR MUDALLAL
NPI 1023369097
Internal Medicine in Saint Louis, MO

Active since September 30, 2012PECOS Enrolled
915 N GRAND BLVD, SAINT LOUIS, MO 63106(314) 652-4100 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2024, May 29, 2019 (2 updates tracked since 2019).

About Omar Mudallal NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMAR MUDALLAL (NPI 1023369097) is an individual internal medicine provider in Saint Louis, Missouri, licensed in Illinois (036147331) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023369097
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameOMAR MUDALLAL
Location Address915 N GRAND BLVDSaint Louis, MO 63106-1621
Mailing Address915 N Grand BlvdSaint Louis, MO 63106-1621 · (314) 652-4100
Phone(314) 652-4100
Sole ProprietorNo
Enumeration DateSeptember 30, 2012
Last NPPES UpdateApril 2, 20242 updates tracked since enumeration
NPPES CertifiedApril 2, 2024
✔ NPI 1023369097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036147331
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
915 N GRAND BLVD, Saint Louis, MO 63106
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omar Mudallal is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW CHRISTOPHER SIMPSON O.D.
Optometrist
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
MS. CHARMIN MEYATTA GIBSON M.S.W.
Social Worker
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4110
CONOR MCCARTNEY M.D.
Internal Medicine
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
ALITA BILLOPS CNP
Nurse Practitioner (Primary Care)
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
STEPHANIE ADAMS
Registered Nurse
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 289-7676
NAGLA ABDELMALEK M.D.
Emergency Medicine
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
DR. JAMES MICHAEL HASIK DDS
Dentist (General Practice)
915 N GRAND BLVD, DENTAL CLINIC
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
MS. TRACY LANES CRNA
Nurse Anesthetist, Certified Registered
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omar Mudallal's NPI number?

The NPI number for Omar Mudallal is 1023369097. It was assigned to this individual provider in the NPPES registry on September 30, 2012.

Where is Omar Mudallal located?

Omar Mudallal practices at 915 N Grand Blvd, Saint Louis, MO 63106. The listed phone number is (314) 652-4100.

What is Omar Mudallal's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Omar Mudallal enrolled in Medicare?

Yes. Omar Mudallal is registered in the Medicare PECOS enrollment system.

What insurance does Omar Mudallal accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Omar Mudallal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Omar Mudallal was last updated on April 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.