Individual provider Active NPI

Joshua Koleske, MD

  • Neurological Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1407690688
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
2024022333 Issued in MO
Practice address
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone
(314) 362-3570
NPI assigned
Jun 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 2024022333 MO Primary

Addresses

Primary practice location

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave # 8057
Saint Louis, MO 63110-1010
Phone (314) 362-3570

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
I20240702000341 MO Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5991249997

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024022333MOMDNeurological Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1407690688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE # 8057",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEW HOSP PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESKE",
        "first_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2024022333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.