Organization Active NPI

Vax Concierge Mo PC

  • Allergy & Immunology Physician
  • University City, MO
National Provider Identifier
1639014541
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
VAX CONCIERGE MO PC
Practice address
8150 Amherst Ave
University City, MO 63130-3605
Phone
(773) 260-0964
NPI assigned
Apr 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Judah Kanowitz
Title
Owner
Phone
(773) 260-0964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

8150 Amherst Ave
University City, MO 63130-3605

Mailing address

8150 Amherst Ave
University City, MO 63130-3605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260605002688 MO Part B Supplier - Clinic/Group Practice 5991276354 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1639014541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 AMHERST AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 AMHERST AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303605",
            "telephone_number": "773-260-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAX CONCIERGE MO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "KANOWITZ",
        "authorized_official_first_name": "JUDAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-260-0964"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.