Individual provider Active NPI

Robert Kocur, M.D.

  • Allergy Physician
  • Saint Louis, MO
National Provider Identifier
1689773541
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
R7H71 Issued in MO
Practice address
777 S New Ballas Rd
Suite 216W
Saint Louis, MO 63141-8705
Phone
(314) 569-2015
Fax
(314) 569-2016
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X R7H71 MO Primary

Addresses

Primary practice location

777 S New Ballas Rd
Suite 216W
Saint Louis, MO 63141-8705

Mailing address

777 S New Ballas Rd
Suite 216W
Saint Louis, MO 63141-8705
Phone (314) 569-2015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20151125001876 IL Practitioner - Allergy/Immunology 8224161013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Saint Louis University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1701 E College Ave
Bloomington, IL 61704-2101
Phone (309) 664-3130

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R7H71MOMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients

Locations

1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000

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

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1689773541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "SUITE 216W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-569-2015",
            "fax_number": "314-569-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "SUITE 216W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-569-2015",
            "fax_number": "314-569-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCUR",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MO",
            "license": "R7H71",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.