Individual provider Active NPI

Kamlesh B Patel, MD

  • Plastic and Reconstructive Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1790766186
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
2011020088 Issued in MO
Practice address
4921 Parkview PL
Div Surg Plastics, Ste 6G
Saint Louis, MO 63110-1032
Phone
(314) 362-7388
Fax
(833) 301-0853
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 2011020088 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Div Surg Plastics, Ste 6G
Saint Louis, MO 63110-1032

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-7388

Other identifiers 1

IdentifierTypeStateIssuer
205625601MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110923000594 MO Practitioner - Plastic and Reconstructive Surgery 8224152806 Reassigns benefits to 2 organizations
I20200413001028 IL Practitioner - Plastic and Reconstructive Surgery 8224152806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Arizona College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 454-6000

4921 Parkview PL
Suite G6TH
Saint Louis, MO 63110-1032
Phone (314) 362-7388

Hospital & facility affiliations

  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011020088MOMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc CurrentSince Mar 10, 2020 Accepting new patients
Mercy Clinic Burn and Plastic Surgery, LLC Plastic Surgery CurrentSince Oct 27, 2023 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Mar 10, 2020 Accepting new patients
Ozarks Medical Center Past Accepting new patients
St. Louis Children'S Hospital Past Accepting new patients
Washington University Past Accepting new patients

Locations

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

2 Progress Point Pkwy
O Fallon, MO 63368
Phone (636) 344-1000

1 Childrens Pl
Ste 2A
Saint Louis, MO 63110
Phone (314) 454-6022

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

4921 Parkview Pl
Ste 6G
Saint Louis, MO 63110
Phone (314) 362-7388

701 S New Ballas Rd
Ste 310
Saint Louis, MO 63141
Phone (314) 251-8750

1 Childrens Pl
Ste 3S32
Saint Louis, MO 63110
Phone (727) 218-2420

4240 Duncan Ave
Ste 301
Saint Louis, MO 63110

Interoperability endpoints

  • Direct secure messaging: kpatel173716@direct.carenet.org
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 8

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1790766186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-7388",
            "fax_number": "833-301-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DIV SURG PLASTICS, STE 6G",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-7388",
            "fax_number": "833-301-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAMLESH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MO",
            "license": "2011020088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205625601",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Div Surg Plastics, Ste 6G",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.