NPIMap

Individual provider Active NPI

Kenneth Richard Kilian, M.D.

  • Family Medicine Physician
  • Festus, MO
National Provider Identifier
1225023955
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2002022533 Issued in MO
Practice address
1390 Highway 61
Suite 2200
Festus, MO 63028-4137
Phone
(636) 933-9300
Fax
(636) 933-9114
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2002022533 MO Primary

Addresses

Primary practice location

1390 Highway 61
Suite 2200
Festus, MO 63028-4137

Mailing address

1390 Highway 61
Suite 2200
Festus, MO 63028-4137
Phone (636) 933-9300

Other identifiers 3

IdentifierTypeStateIssuer
P01222334OtherMORAILROAD MEDICARE
1225023955MedicaidMO
203307137MedicaidMO

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
I20101020001076 MO Practitioner - Family Practice 5395701874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 189a
Saint Louis, MO 63141-8255
Phone (314) 251-6335

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • Amedisys Home Health of Missouri Home health agency, Hillsboro, MO, CCN 267270
  • Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
  • Mercy Home Health Home health agency, Festus, MO, CCN 267217
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Jefferson PastSince Apr 30, 2003 Accepting new patients
Twin City Internal Medicine Specialists, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kkilian414478@directc.mercy.net

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.

Hospital & facility affiliations 6

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1225023955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 HIGHWAY 61",
            "address_2": "SUITE 2200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-9300",
            "fax_number": "636-933-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 HIGHWAY 61",
            "address_2": "SUITE 2200",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-9300",
            "fax_number": "636-933-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILIAN",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2002022533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01222334",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225023955",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203307137",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.