Individual provider Active NPI

Kemdi Egekeze, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1609452085
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024033046 Issued in MO
Practice address
4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647
Phone
(314) 843-7557
Fax
(314) 849-8671
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2024033046 MO Primary

Addresses

Primary practice location

4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647

Mailing address

PO Box 776084
Chicago, IL 60677-6084

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
I20240913002241 MO Practitioner - Family Practice 0749681831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647
Phone (314) 843-7557

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Sep 23, 2024 Accepting new patients

Locations

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

4460 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 843-7557

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

Organizations & group practices 1

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 3

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1609452085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 S LINDBERGH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271647",
            "telephone_number": "314-843-7557",
            "fax_number": "314-849-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGEKEZE",
        "first_name": "KEMDI",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2024033046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.