Individual provider Active NPI

Teresa Anne Kurtz, MD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1043379241
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010017705 Issued in MO
Practice address
4850 Lemay Ferry Rd
Ste 120
Saint Louis, MO 63129-1526
Phone
(314) 849-3320
Fax
(314) 849-7766
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2010017705 MO Primary

Addresses

Primary practice location

4850 Lemay Ferry Rd
Ste 120
Saint Louis, MO 63129-1526

Mailing address

PO Box 7412065
Chicago, IL 60674-2065
Phone (314) 849-3320

Other identifiers 1

IdentifierTypeStateIssuer
204273502MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910001142 MO Practitioner - Pediatric Medicine 2860559358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010017705MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Sep 16, 2024 Accepting new patients
Washington University Pediatrics Current Accepting new patients
Washington University CurrentSince Sep 16, 2024 Accepting new patients
Washington University Past Accepting new patients

Locations

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

1 Childrens Pl
#8328
Saint Louis, MO 63110

4850 Lemay Ferry Rd
Ste 120
Saint Louis, MO 63129
Phone (314) 416-1707

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

456 N New Ballas Rd
Ste 304
Saint Louis, MO 63141
Phone (314) 567-0578

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1043379241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412065",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742065",
            "telephone_number": "314-849-3320",
            "fax_number": "314-849-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD",
            "address_2": "STE 120",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291526",
            "telephone_number": "314-849-3320",
            "fax_number": "314-849-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "TERESA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2010017705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204273502",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4850 LeMay Ferry Rd",
            "address_2": "Ste 120",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631291526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.