Individual provider Active NPI

Pulcherie Guissou Ada, MD

  • Hospitalist Physician
  • Columbia, MO
National Provider Identifier
1265039218
Registry record updated Mar 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
01092542A Issued in IN
Practice address
404 N Keene St
Columbia, MO 65201-6626
Phone
(573) 882-4438
NPI assigned
Oct 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2023049015 MO
Pediatrics Physician 208000000X 2023049015 MO
Hospitalist Physician 208M00000X 01092542A IN Primary

Addresses

Primary practice location

404 N Keene St
Columbia, MO 65201-6626

Mailing address

400 N Keene St
Columbia, MO 65201-6626
Phone (573) 882-4438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241017003754 IN Practitioner - Hospitalist 3375948920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023049015MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Deaconess Hospital Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1265039218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-882-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-882-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUISSOU ADA",
        "first_name": "PULCHERIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2023049015",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2023049015",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01092542A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.