Individual provider Active NPI

Andrew Brian Kichura, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1265794432
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2012017263 Issued in MO
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

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630000240 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - HospitalistPractitioner - Internal Medicine 3678885902 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Hospitalist, Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012017263MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 14, 2015 Accepting new patients
SSM Health Care St Louis CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 14, 2015 Accepting new patients
SSM Medical Group Inc. CurrentSince Jul 1, 2019 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.