Individual provider Active NPI

Jeffrey A Parres, MD

  • Urology Physician
  • Maryville, IL
National Provider Identifier
1619951027
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036-083896 Issued in IL
Practice address
6812 State Route 162 Ste 200
Maryville, IL 62062-8562
Phone
(618) 288-0900
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 100027 MO
Urology Physician 208800000X 036-083896 IL Primary

Addresses

Primary practice location

6812 State Route 162 Ste 200
Maryville, IL 62062-8562

Mailing address

12855 N 40 Dr
Suite 375
Saint Louis, MO 63141-8635
Phone (314) 567-6071

Other practice location 1

3 Saint Elizabeth Blvd Ste 3200
O Fallon, IL 62269-1281
Phone (618) 489-8030

Other practice location 2

326 Fountains Pkwy
Fairview Heights, IL 62208-2041
Phone (618) 277-3109

Other practice location 3

12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657
Phone (314) 567-6071

Other identifiers 1

IdentifierTypeStateIssuer
203454715MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE) Missouri Baptist Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, 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

Enrollment IDStateProvider typePAC IDDetails
I20100629000801 IL Practitioner - Urology 3678460169 Reassigns benefits to 3 organizations
I20100823000455 MO Practitioner - Urology 3678460169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Ohio, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians

Practice addresses (Care Compare)

12855 N 40 Dr
Suite 375
Saint Louis, MO 63141-8657
Phone (314) 567-6071

6812 State Route 162 200
Maryville, IL 62062-8562
Phone (618) 288-0900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-083896ILMDUrology Physician
100027MOMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of St. Louis, Inc. Urology CurrentSince Jan 1, 1987 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Urology of St. Louis, Inc. CurrentSince Jan 1, 1987 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 1, 2023 Accepting new patients
Ahs Il Medical Group LLC CurrentSince Oct 8, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Urology of St. Louis, Inc. Urology Past Accepting new patients

Locations

2 Memorial Dr
Ste 102
Alton, IL 62002
Phone (618) 288-0900

2 Saint Anthonys Way
Ste 105
Alton, IL 62002
Phone (618) 465-2761

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

326 Fountains Pkwy
Fairview Heights, IL 62208
Phone (618) 277-3109

2044 Madison Ave
Ste G7
Granite City, IL 62040
Phone (314) 500-2424

12860 Troxler Ave
Ste 135
Highland, IL 62249
Phone (618) 235-3687

6812 State Route 162
Ste 200
Maryville, IL 62062
Phone (618) 288-0900

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

3 Saint Elizabeth Blvd
Ste 3200
O Fallon, IL 62269
Phone (618) 489-8030

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

215 Dunn Rd
Florissant, MO 63031
Phone (314) 315-9911

12855 N 40 Dr
Ste 375
Saint Louis, MO 63141

456 N New Ballas Rd
Ste 348
Saint Louis, MO 63141
Phone (314) 548-0265

12855 N 40 Dr
Saint Louis, MO 63141
Phone (314) 432-4415

Interoperability endpoints

  • Direct secure messaging: jparres@yourcarecommunity.org
  • Direct secure messaging: jeffreyparres@slus.allscriptsdirect.net

Organizations & group practices 7

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 7

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1619951027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR",
            "address_2": "SUITE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418635",
            "telephone_number": "314-567-6071",
            "fax_number": "314-567-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 STATE ROUTE 162 STE 200",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628562",
            "telephone_number": "618-288-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 3200",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691281",
            "country_code": "US",
            "telephone_number": "618-489-8030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 Fountains Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622082041",
            "country_code": "US",
            "telephone_number": "618-277-3109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12855 N 40 Dr Ste 375",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418657",
            "country_code": "US",
            "telephone_number": "314-567-6071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARRES",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "100027",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036-083896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203454715",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "Y",
            "endpointDescription": "bjc",
            "affiliationName": "Missouri Baptist Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12855 N 40 Dr Ste 375",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.