Individual provider Active NPI

Pamela L Kuda, APN-BC

  • Adult Health Nurse Practitioner
  • O Fallon, MO
National Provider Identifier
1295775989
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
101674 Issued in MO
Practice address
1464 Sunburst Dr
O Fallon, MO 63366-6348
Phone
(314) 432-9270
Fax
(314) 432-9271
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 101674 MO Primary

Addresses

Primary practice location

1464 Sunburst Dr
O Fallon, MO 63366-6348

Mailing address

1464 Sunburst Dr
O Fallon, MO 63366-6348
Phone (314) 432-9270

Other identifiers 1

IdentifierTypeStateIssuer
1295775989MedicaidMO

Other names 1

  • Pamela L Kras Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051102000722 MO Practitioner - Nurse Practitioner 3072531680 Receives reassigned benefits from 4 practitioners
Practice locations: De Soto, MO; Union, MO; Town & Country, MO; Ste Genevieve, MO; St Louis, MO; Saint Louis, MO; Saint Clair, MO; Saint Charles, MO…
I20210126003214 IL Practitioner - Nurse Practitioner 3072531680 Receives reassigned benefits from 1 practitioner
Practice locations: Waterloo, IL; Vienna, IL; O Fallon, MO; Eldorado, IL; Anna, IL; Metropolis, IL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 New Ballas Rd
Brookdale of Creve Coeur Assisted Living
Saint Louis, MO 63146-8700
Phone (314) 252-0722

1035 Plaza CT N
Saint Clair Nursing Center
Saint Clair, MO 63077-1129
Phone (636) 629-2100

1464 Sunburst Dr
O Fallon, MO 63366-6348

2 McKnight PL
Saint Louis, MO 63124-1900
Phone (314) 993-2221

3 McKnight PL
Saint Louis, MO 63124-1900
Phone (314) 997-5333

605 Coeur de Ville Dr
Saint Louis, MO 63141-6603
Phone (314) 542-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Madhuram LLC Past Accepting new patients
Mobile Wound Solutions, LLC Past Accepting new patients
Practice of Rosemary Cannistraro, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15764/brand/1/csg/1/fhir/r4
  • Direct secure messaging: pamelakuda_31999@cp.omnimddirect.com

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1295775989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 SUNBURST DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633666348",
            "telephone_number": "314-432-9270",
            "fax_number": "314-432-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 SUNBURST DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633666348",
            "telephone_number": "314-432-9270",
            "fax_number": "314-432-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDA",
        "first_name": "PAMELA",
        "middle_name": "L",
        "credential": "APN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "101674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295775989",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "KRAS",
            "middle_name": "L",
            "credential": "APN-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.