ALEXANDRA BAHAR KHODADADI MD, MSPH
NPI 1114543832
Internal Medicine in Crystal Cty, MO

Q: What is Alexandra Khodadadi's NPI number?

The NPI number for Alexandra Khodadadi is 1114543832. It was assigned to this individual provider in the NPPES registry on June 18, 2020.

Q: What is Alexandra Khodadadi's specialty?

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

Active since June 18, 2020PECOS Enrolled

1400 US HIGHWAY 61, CRYSTAL CTY, MO 63028(636) 933-5337 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 18, 2026, Sep 15, 2025, Jun 18, 2020 (3 updates tracked since 2020).

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About Alexandra Bahar Khodadadi Md, Msph NPPES

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

ALEXANDRA BAHAR KHODADADI MD, MSPH (NPI 1114543832) is an individual internal medicine provider in Crystal Cty, Missouri, licensed in Missouri (2022049388) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1114543832

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameALEXANDRA BAHAR KHODADADICredential: MD, MSPH

Location Address1400 US HIGHWAY 61Crystal Cty, MO 63028-4108

Mailing Address1400 Us Highway 61Crystal Cty, MO 63028-4108 · (636) 933-5337

Phone(636) 933-5337

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateJune 18, 2020

Last NPPES UpdateAugust 18, 20263 updates tracked since enumeration

NPPES CertifiedAugust 18, 2026

✔ NPI 1114543832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MO · 2022049388

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.

1400 US HIGHWAY 61, Crystal Cty, MO 63028

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexandra Bahar Khodadadi Md, Msph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062836984

PECOS Enrollment IDI20260822000872

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.

Medicare Billing Reassignment

Medicare enrollment records show Alexandra Khodadadi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mercy Clinic Adult Critical Care, LLC

33 mi

Critical Care Medicine

621 S NEW BALLAS RD, SUITE 4006-B
Saint Louis, MO 63141

Reassigned Medicare billing, Missouri enrollment
77 clinicians in this Medicare group

NPI 1730119421 (314) 251-6486

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63028 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.

MERCY HEALTH SERVICES, LLC

Pharmacy (Community/Retail Pharmacy)

1400 US HIGHWAY 61, STE G38
FESTUS, MO 63028

Jefferson County (636) 933-1600

KARTHIK IYER MD

Internal Medicine (Critical Care Medicine)