Active NPI
Andrew Brian Kichura, M.D.
- Internal Medicine Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2012017263
- Practice address
- 1402 S Grand Blvd
FDT 14TH Floor
Saint Louis, MO 63104-1004 - Phone
- (314) 577-8762
- NPI assigned
- Jun 13, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 2012017263 | MO | |
| Internal Medicine Physician | 207R00000X | 2012017263 | MO | Primary |
Addresses
Primary practice location
1402 S Grand Blvd
FDT 14TH Floor
Saint Louis, MO 63104-1004
Mailing address
1402 S Grand Blvd
FDT 14TH Floor
Saint Louis, MO 63104-1004
Phone (314) 577-8762
Other practice location 1
1027 Bellevue Ave Ste 200
Saint Louis, MO 63117-1851
Phone (314) 645-6450
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | akichura236713@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1027 Bellevue Ave
Suite 200
Saint Louis, MO 63117-1851
Phone (314) 645-6450
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8000
Hospital & facility affiliations
- SSM Health St Mary'S Hospital - St Louis
- SSM St Clare Health Center
- Barnes Jewish Hospital
- SSM Health Saint Louis University Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012017263 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| SSM Health Care St Louis | Current | Accepting new patients | |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| SSM Medical Group Inc. | Current | Accepting new patients | |
| SSM Health Care St. Louis | Internal Medicine | Past | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
1011 Bowles Ave
Ste 205
Fenton, MO 63026
Phone (314) 966-8118
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
1027 Bellevue Ave
Ste 200
Saint Louis, MO 63117
Phone (314) 644-3336
3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442
Interoperability endpoints
- akichura236713@direct-ehr-ssmhc.com
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Clinic/Center
- Saint Louis, MO
- NPI 1851431738
-
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
-
- Durable Medical Equipment & Medical Supplies
- Warrenton, MO
- NPI 1467997155
-
- Emergency Medicine Physician
- Saint Charles, MO
- NPI 1427002922
Internal Medicine
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
- General Acute Care Hospital
- Fenton, MO
- NPI 1851496152
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1265794432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 S GRAND BLVD",
"address_2": "FDT 14TH FLOOR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041004",
"telephone_number": "314-577-8762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 S GRAND BLVD",
"address_2": "FDT 14TH FLOOR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041004",
"telephone_number": "314-577-8762"
}
],
"practiceLocations": [
{
"address_1": "1027 Bellevue Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631171851",
"country_code": "US",
"telephone_number": "314-645-6450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KICHURA",
"first_name": "ANDREW",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-13",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MO",
"license": "2012017263",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2012017263",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "akichura236713@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "akichura236713@direct-ehr-ssmhc.com",
"address_1": "1027 Bellevue Ave Ste 200",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631171851",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1027 Bellevue Ave Ste 200",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631171851",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.