Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mohan Babu Palla, MD

Individual provider Internal Medicine Physician · NPI 1477998896

Dr. Mohan Babu Palla, MD is an Interventional Cardiology in Fenton, Missouri. Qualified in 2007, 19 years ago. Practices with Mat-Su Valley III LLC, a 25-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Illinois, Maryland, Missouri and North Dakota.

Years since qualifying
19
Licensed in
IL, MD, MO, ND
In the registry since
2013
Specialties on file
10
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1011 Bowles Ave Ste 300
Fenton, MO 63026-2387
Phone: (636) 496-5065
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 — (217) 788-0706
  • 12502 Willowbrook Rd, Cumberland, MD 21502-6491 — (240) 964-8724
  • 12500 Willowbrook Rd, Cumberland, MD 21502-6393 — (240) 964-7000
  • 4201 Saint Antoine St, Detroit, MI 48201-2153 — (313) 745-4525

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 2025017659 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence D90794 (MD)
Internal Medicine Physician Taxonomy 207R00000X · Licence 036160962 (IL)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence D90794 (MD)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 036160962 (IL)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 21166 (ND)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence PENDING (MD)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 036160962 (IL)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence D9074 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1477998896
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 30, 2013
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Mat-Su Valley Iii Llc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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