NPIMap

Individual provider Active NPI

John J Dubois, D.O.

  • Internal Medicine Physician
  • Eureka, MO
National Provider Identifier
1538264205
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2002004657 Issued in MO
Practice address
20 The Legends Pkwy
Eureka, MO 63025-3801
Phone
(636) 549-0121
Fax
(636) 549-0122
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2002004657 MO Primary

Addresses

Primary practice location

20 The Legends Pkwy
Eureka, MO 63025-3801

Mailing address

20 The Legends Parkway
Eureka, MO 63025
Phone (636) 549-0121

Other identifiers 1

IdentifierTypeStateIssuer
245859301MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000200 MO Practitioner - Internal Medicine 3274503800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

20 The Legends Pkwy
Eureka, MO 63025-3823
Phone (636) 938-3399

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
  • Mercy Hospice Hospice, Saint Louis, MO, CCN 261510
  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Eureka Medical LLC Internal Medicine Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

20 The Legends Pkwy
Ste 100
Eureka, MO 63025
Phone (636) 549-0121

1015 Bowles Ave
Ste 1000
Fenton, MO 63026
Phone (636) 390-1400

9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

Interoperability endpoints

  • Direct secure messaging: jdubois326297@directc.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1538264205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 THE LEGENDS PARKWAY",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "63025",
            "telephone_number": "636-549-0121",
            "fax_number": "636-549-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 THE LEGENDS PKWY",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630253801",
            "telephone_number": "636-549-0121",
            "fax_number": "636-549-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2002004657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245859301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, MO

Sources for this page

Verify at the official NPI Registry.