Willis Ko, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036171090 Issued in IL

Practice address

6810 State Route 162 Ste 102B
Maryville, IL 62062-8560

Phone

(618) 288-4076

Fax

(618) 288-4215

NPI assigned

Jun 1, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional Cardiology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

92.87

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group NPD
• SSM Medical Group, Inc.

  dba SSM Health Medical Group

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  Medicare reassignment Care Compare group
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD

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

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  dba Christian Hospital

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Clare Hospital - Fenton

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1215465307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418512",
            "telephone_number": "314-448-3791",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 STE 102B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628560",
            "telephone_number": "618-288-4076",
            "fax_number": "618-288-4215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 14th St SW",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337703133",
            "country_code": "US",
            "telephone_number": "727-588-3700",
            "fax_number": "727-585-7205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5645 Main St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113555045",
            "country_code": "US",
            "telephone_number": "718-670-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 N Broad Street",
            "address_2": "Hahnemann University Hospital",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19102",
            "country_code": "US",
            "telephone_number": "215-762-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KO",
        "first_name": "WILLIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036171090",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MT213475",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT213475",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2024024174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wik9026@nyp.org",
            "affiliation": "Y",
            "affiliationName": "New York Presbyterian Queens",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "6810 State Route 162 Ste 102B",
            "city": "Maryville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620628560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Joy Kilzer, FNP-C
• Melissa Kimes
• David W Kinscherff, DPM
• Christina Kittstein, LLC
• Heather N Knudson, MA, SLP
• Gretchen A Koehne, LCPC
• Kristina Michele Kohler
• Tibor Charles Kopjas, M.D.
• Kristen R Kreher, NP
• Jennifer Dawn Krick, M.D.

• Interventional Cardiology Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.