Individual provider Active NPI

Kumaran Chinnappan, MD,FACS,FRCS,FASMBS

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1346417250
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2010017407 Issued in MO
Practice address
12152 Tesson Ferry Rd Ste B
Saint Louis, MO 63128-1779
Phone
(314) 858-6172
NPI assigned
May 9, 2008
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2010017407 MO Primary

Addresses

Primary practice location

12152 Tesson Ferry Rd Ste B
Saint Louis, MO 63128-1779

Mailing address

9621 Olive Blvd #8344
Saint Louis, MO 63132-9998
Phone (314) 690-1527

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
I20110614000747 MO Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology)Practitioner - Surgical OncologyPractitioner - Other (Physician) 7911055132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology), Surgical Oncology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 690-1527

1400 Hwy 61 S
Mercy Hosp Jefferson
Festus, MO 63028-4100
Phone (314) 690-1527

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
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
2010017407MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arch Bariatrics LLC Surgery CurrentSince Jul 27, 2015 Accepting new patients
Geisinger Clinic Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10007 Kennerly Rd
Ste A
Saint Louis, MO 63128
Phone (314) 690-1552

12152 Tesson Ferry Rd
Ste B
Saint Louis, MO 63128
Phone (314) 858-6172

1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955

3933 S Broadway
Saint Louis, MO 63118
Phone (314) 865-3333

9621 Olive Blvd
Unit 8344
Saint Louis, MO 63132

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1346417250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 OLIVE BLVD #8344",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631329998",
            "telephone_number": "314-690-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12152 TESSON FERRY RD STE B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281779",
            "telephone_number": "314-858-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINNAPPAN",
        "first_name": "KUMARAN",
        "credential": "MD,FACS,FRCS,FASMBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2010017407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.