Deepak Koul, MD, FACC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

2010015943 Issued in MO

Practice address

1225 Graham Rd Ste C-2310
Florissant, MO 63031-8023

Phone

(314) 953-6300

NPI assigned

Jul 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: dkoul11411@direct.carenet.org

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.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Cardiovascular Disease

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  dba Christian Hospital

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1417155672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-2310",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318023",
            "telephone_number": "314-953-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-2310",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318023",
            "telephone_number": "314-953-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Graham Rd",
            "address_2": "Bld C, Ste 2310",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630318012",
            "country_code": "US",
            "telephone_number": "314-953-6300",
            "fax_number": "314-953-6309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6810 State Route 162 Ste 102",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620628560",
            "country_code": "US",
            "telephone_number": "618-288-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOUL",
        "first_name": "DEEPAK",
        "name_prefix": "Dr.",
        "credential": "MD, FACC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2010015943",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036126770",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036126770",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2010015943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Graham Rd Ste C-2310",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard A Koch, M.D.
• Vijaya Kode
• Lisa A Kohnen, OTR
• Akiya Kollore
• Joanna D Kostopoulos, OTR/L
• Rachel Elizabeth Kozinski, PHARMD
• Stephen E Kraft, MD
• Marcel Kroni, DDS
• Tori Kruel, MSW, LCSW, PEL:SSW
• Jennifer Anne Kuhn, RRT

• Cardiovascular Disease Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.

Verify at the official NPI Registry.