Michael Kolessar, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

12380 De Paul Dr
Bridgeton, MO 63044-2511

Phone

(314) 447-9705

NPI assigned

Dec 18, 2009

Last updated

Oct 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ability KCGroup PAC ID 0143116368, 166 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ability KC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Kansas City, MO
  • NPI 1598746836
  Medicare reassignment Care Compare group NPD
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Physical Medicine & Rehabilitation Physician
  • Dallas, TX
  • NPI 1932174984
  NPD

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1134458201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12380 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442511",
            "telephone_number": "314-447-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442511",
            "telephone_number": "314-447-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESSAR",
        "first_name": "MICHAEL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-18",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Joseph Knotts, NP
• Timothy R Knuuttila, D.C.
• Nand K Kodwani, MD
• Martha J Koenegstein, CPNP
• Elizabeth Ann Koenig
• Jordan Konsewicz, MSW, LMSW
• Janet Kontz, LPC
• Kathleen Konys, NP-C
• Ashley Kooima, BCBA
• Jessica Kos

• Clinical Neuropsychologist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Clinical Neuropsychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.