Pavilion Health Company, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PAVILION HEALTH COMPANY, LLC

Practice address

11520 Saint Charles Rock Rd Ste 105a
Bridgeton, MO 63044-2732

Phone

(314) 312-5588

NPI assigned

Dec 7, 2020

Organization subpart

No

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

Authorized official

Name

Nagaraj V Kunda

Title

Director/Owner

Phone

(314) 377-9110

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Pavilion Healthcare Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Pavilion Health Company LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Pavilion Health Company, LLC

  • Home Health Agency
  • Bridgeton, MO
  • NPI 1306796073
  NPD tax ID
• Pavilion Health Company, LLC

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
  • NPI 1508693474
  NPD tax ID
• Pavilion Health Company, LLC

  • Durable Medical Equipment & Medical Supplies
  • Wasilla, AK
  • NPI 1659108579
  NPD tax ID

Locations

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1780280693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 SAINT CHARLES ROCK RD STE 105A",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442732",
            "telephone_number": "314-312-5588",
            "fax_number": "314-377-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11520 SAINT CHARLES ROCK RD STE 105A",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442732",
            "telephone_number": "314-312-5588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2421 E Tudor Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995071166",
            "country_code": "US",
            "telephone_number": "314-312-5588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAVILION HEALTH COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "KUNDA",
        "authorized_official_first_name": "NAGARAJ",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "314-377-9110"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620112387",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.pavilion.care",
            "affiliation": "N",
            "address_1": "11520 Saint Charles Rock Rd Ste 105A",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pavilion Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jacqueline Pecoraro
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• Kristin Percy, OTR/L
• Isabel B Perez, MD
• Jeannie Ong Perez, MD

• Durable Medical Equipment & Medical Supplies in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.