Active NPI
Kosit Prieb, M.D.
- Vascular Surgery Physician
- Belleville, IL
National Provider Identifier
1033154190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 036-047055
- Practice address
- 311 W Lincoln St
Suite 200
Belleville, IL 62220-1902 - Phone
- (618) 233-2500
- Fax
- (618) 233-2520
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 036-047055 | IL | Primary |
Addresses
Primary practice location
311 W Lincoln St
Suite 200
Belleville, IL 62220-1902
Mailing address
379 Oak Hill Dr
Belleville, IL 62223-2231
Phone (618) 398-0231
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036047055 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-047055 | IL | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Surgical Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ambulatory Surgical Clinic/Center
- Belleville, IL
- NPI 1972548626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1033154190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "379 OAK HILL DR",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622232231",
"telephone_number": "618-398-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W LINCOLN ST",
"address_2": "SUITE 200",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201902",
"telephone_number": "618-233-2500",
"fax_number": "618-233-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIEB",
"first_name": "KOSIT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "IL",
"license": "036-047055",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036047055",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belleville, IL
- Premier Internal Medicine LLC
- Premier Pathology Services LLC
- Premise Health of Illinois Medical PC (St Claire - Belleville)
- Sarah Price, M.D.
- Susan Elizabeth Price, SSP, MAED
- Prima Donna Salon
- Sarah E Pringle, CNP
- Roberta Cheryl Pritchard-Palmer, APRN,BC
- Professional Supportive Solution Therapy
- Prometheus Rises PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.