Nicholas Gourtzelis, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

2005006931 Issued in MO

Practice address

10004 Kennerly Rd
Ste 374B
St Louis, MO 63128

Phone

(314) 842-9669

Fax

(314) 842-1017

NPI assigned

May 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nephrology

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NHS South LLCGroup PAC ID 1658797246, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FMC - Tesson Ferry Dialysis Dialysis facility, Saint Louis, MO, CCN 262619
• DaVita Arnold Dialysis Dialysis facility, Arnold, MO, CCN 262647
• DaVita Lamplighter Dialysis Dialysis facility, Saint Louis, MO, CCN 262606
• South Towne Square Dialysis Clinic Dialysis facility, Saint Louis, MO, CCN 262615
• Alternative Hospice, LLC Hospice, Fenton, MO, CCN 261613
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• Mercy Rehabilitation Hospital St Louis Inpatient rehabilitation facility, Chesterfield, MO, CCN 263029
• Mercy Rehabilitation Hospital South Inpatient rehabilitation facility, Saint Louis, MO, CCN 263034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 44)

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.

• NHS South LLC

  • Nephrology Physician
  • Saint Louis, MO
  • NPI 1376166066
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nra-South City, Missouri, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1225079395

  Dialysis facility

  Care Compare affiliation Name & address match
• Renal Treatment Centers-Illinois Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1649210824

  Dialysis facility

  Care Compare affiliation Name & address match
• Saint Louis Renal Care, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1215083043

  Dialysis facility

  Care Compare affiliation Name & address match
• Alternative Hospice LLC

  • Community Based Hospice Care Agency
  • Fenton, MO
  • NPI 1144381492
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Mercy Rehabilitation Hospital - St Louis, LLC

  • Rehabilitation Hospital
  • Chesterfield, MO
  • NPI 1811048614

  Inpatient rehabilitation facility

  Care Compare affiliation
• Mercy Rehabilitation Hospital South LLC

  • Rehabilitation Hospital
  • St Louis, MO
  • NPI 1992435895

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1790734994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802841",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802841",
            "telephone_number": "314-842-9669",
            "fax_number": "314-842-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "STE 374B",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-842-9669",
            "fax_number": "314-842-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURTZELIS",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2005006931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207376708",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Suzanne Gould, LPC
• Ronald John Gould, M.D.
• Eric Goulden, PHARM.D
• I Regina Gourdine, MSW , LCSW
• Ally Marie Gourley
• Kathy Lynn Gouwens, M.A., PLPC
• Laurel J Governal, BCBA
• Christie R Govero, FNP
• Ramaswamy Govindan, MD
• Shiv Govindji, MD

• Nephrology Physician in St Louis, MO
• Providers in St Louis, MO by specialty
• Nephrology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.