Shalen Kouk, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

2022039230 Issued in MO

Practice address

12700 Southfork Rd Ste 100
Saint Louis, MO 63128-3201

Phone

(314) 543-5284

Fax

(314) 543-5276

NPI assigned

May 6, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, MO2 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

Orthopedic SurgeryAlso: Sports Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Health Home health agency, Saint Louis, MO, CCN 267253
• Evertrue Home Health Home health agency, St. Louis, MO, CCN 267530
• Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mercy Clinic Surgical Specialists, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1043530538
  Medicare reassignment Care Compare group NPD
• STV Sports Medicine & Orthopedics LLC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Birmingham, AL
  • NPI 1467818575

  Orthopaedic Surgery

  Medicare reassignment NPD
• STV Sports Medicine & Orthopedics LLC

  • Durable Medical Equipment & Medical Supplies
  • Pelham, AL
  • NPI 1770365504

  Orthopaedic Surgery

  NPD
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

• Mercy Hospital South

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1053314179
  Care Compare affiliation Name & address match
• Lutheran Senior Services

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1770664161
  Care Compare affiliation
• Mercy Health Services LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1154407112
  Care Compare affiliation
• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1558748871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-543-5284",
            "fax_number": "314-543-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-543-5284",
            "fax_number": "314-543-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUK",
        "first_name": "SHALEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2023-03-21",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "MD.40953",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2022039230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence M Kotner, MD
• Brandy Kotzamanis
• Paul Thomas Kotzbauer, MD
• Adou Kouame, MD
• Nicholas Kouchoukos, MD
• Carole C Kounga, MD
• Stephanie Kovac
• Maghy Anne Kovach, CRNA
• Danielle Barbara Kovacic, PNP
• Attila Kovacs, MD

• Sports Medicine (Orthopaedic Surgery) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.