Individual provider Active NPI

Lindy A Hruska, M.D.

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1174510473
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2005020836 Issued in MO
Practice address
621 S New Ballas Rd
Suite 7011B
Saint Louis, MO 63141-8232
Phone
(314) 251-6840
Fax
(314) 251-7249
NPI assigned
Oct 2, 2005
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2005020836 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 7011B
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Suite 7011B
Saint Louis, MO 63141-8232
Phone (314) 251-6840

Other practice location 1

15945 Clayton Rd Ste 120
Ballwin, MO 63011-2490
Phone (636) 256-5000

Other identifiers 2

IdentifierTypeStateIssuer
1174510473MedicaidMO
P00292874OtherMORAILROAD MEDICARE

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
I20051012001186 MO Practitioner - General Surgery 6709801301 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC Surgery CurrentSince Jun 1, 2012 Accepting new patients
Mercy Clinic St. Louis Cancer and Breast Institute, LLC CurrentSince Jul 18, 2022 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

15945 Clayton Rd
Ste 120
Ballwin, MO 63011
Phone (636) 256-5000

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

621 S New Ballas Rd
Ste 7011B
Saint Louis, MO 63141
Phone (314) 251-6840

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

Interoperability endpoints

  • Direct secure messaging: lhruska99615@directc.mercy.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1174510473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 7011B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6840",
            "fax_number": "314-251-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 7011B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6840",
            "fax_number": "314-251-7249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15945 Clayton Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630112490",
            "country_code": "US",
            "telephone_number": "636-256-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HRUSKA",
        "first_name": "LINDY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-02",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2005020836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174510473",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00292874",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.