NPIMap

Individual provider Active NPI

Brian A Grus, MD

  • Internal Medicine Physician
  • O'Fallon, MO
National Provider Identifier
1053421065
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
101019 Issued in MO
Practice address
20 Progress Point Pkwy Ste 108
O Fallon, MO 63368-2207
Phone
(636) 344-2400
NPI assigned
Aug 30, 2006
Last updated
Feb 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 101019 MO Primary

Addresses

Primary practice location

20 Progress Point Pkwy Ste 108
O Fallon, MO 63368-2207

Mailing address

20 Progress Point Pkwy Ste 108
O Fallon, MO 63368-2207
Phone (636) 344-2400

Other practice location 1

20 Progress Point Pkwy
Ste 108
O Fallon, MO 63368-2206
Phone (636) 344-2400

Other identifiers 1

IdentifierTypeStateIssuer
205144702MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000563 MO Practitioner - Internal Medicine 4688776511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101019MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Mar 1, 1996 Accepting new patients
Physician Groups LC CurrentSince Mar 1, 1996 Accepting new patients
Physician Groups LC Internal Medicine Past Accepting new patients

Locations

2 Progress Point Pkwy
Ste 101
O Fallon, MO 63368
Phone (636) 344-3100

20 Progress Point Pkwy
Ste 108
O Fallon, MO 63368
Phone (636) 344-1073

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

969 N Mason Rd
Ste 160
Saint Louis, MO 63141
Phone (314) 434-8828

Interoperability endpoints

  • Direct secure messaging: bgrus11245@direct.carenet.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1053421065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROGRESS POINT PKWY STE 108",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682207",
            "telephone_number": "636-344-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROGRESS POINT PKWY STE 108",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682207",
            "telephone_number": "636-344-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Progress Point Pkwy",
            "address_2": "Ste 108",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633682206",
            "country_code": "US",
            "telephone_number": "636-344-2400",
            "fax_number": "636-344-2401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUS",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "101019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205144702",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20 Progress Point Pkwy Ste 108",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633682207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.