Individual provider Active NPI

Michael Andrew Kopec, M.D.

  • Anesthesiology Physician
  • Chesterfield, MO
National Provider Identifier
1720215569
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2009015797 Issued in MO
Practice address
222 S Woods Mill Rd Ste 550N
Chesterfield, MO 63017-3641
Phone
(314) 542-4798
Fax
(314) 205-6916
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2009015797 MO Primary

Addresses

Primary practice location

222 S Woods Mill Rd Ste 550N
Chesterfield, MO 63017-3641

Mailing address

2219 Menard St
Saint Louis, MO 63104-4142
Phone (217) 553-4171

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
I20200710001015 MO Practitioner - Anesthesiology 7315176286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rush Medical College of Rush University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Heart Anesthesiology LLCGroup PAC ID 8022042258, 4 clinicians

Practice addresses (Care Compare)

222 S Woods Mill Rd 550
Chesterfield, MO 63017-3625
Phone (314) 542-4798

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009015797MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Open Heart Anesthesiology, LLC Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients

Locations

222 S Woods Mill Rd
Ste 550N
Chesterfield, MO 63017
Phone (314) 434-3049

222 S Woods Mill Rd
Ste 550
Chesterfield, MO 63017
Phone (314) 434-3049

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 1

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1720215569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 MENARD ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631044142",
            "telephone_number": "217-553-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 550N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173641",
            "telephone_number": "314-542-4798",
            "fax_number": "314-205-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPEC",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2009015797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.