Individual provider Active NPI

Patrick Chizek

  • Colon & Rectal Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1245790294
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
2025032761 Issued in MO
Practice address
10012 Kennerly Rd Ste 102
Saint Louis, MO 63128-2197
Phone
(314) 543-5240
Fax
(314) 543-5239
NPI assigned
Mar 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 2025032761 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd Ste 102
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd Ste 102
Saint Louis, MO 63128-2197
Phone (314) 543-5240

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
I20250920000524 MO Practitioner - Colorectal Surgery (Proctology) 2264767862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Gastroenterology LLCGroup PAC ID 8628121795, 66 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 102
Saint Louis, MO 63128-2197
Phone (314) 543-5240

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025032761MOMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Gastroenterology, LLC CurrentSince Sep 15, 2025 Accepting new patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Sep 15, 2025 Accepting new patients

Locations

200 Brevco Plz
Ste 208
Lake St Louis, MO 63367
Phone (314) 251-3880

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

10012 Kennerly Rd
Ste 102
Saint Louis, MO 63128
Phone (314) 525-4225

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

Interoperability endpoints

  • Direct secure messaging: pchizek576425@ahs.direct-ci.com

Organizations & group practices 2

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 3

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1245790294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-543-5240",
            "fax_number": "314-543-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-543-5240",
            "fax_number": "314-543-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIZEK",
        "first_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MO",
            "license": "2025032761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.