Individual provider Active NPI

Charu Kolekar, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Festus, MO
National Provider Identifier
1811320856
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2022037561 Issued in MO
Practice address
1400 US Highway 61
Festus, MO 63028-4100
Phone
(636) 933-5337
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036146491 IL
Hospitalist Physician 208M00000X 036146491 IL
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2022037561 MO Primary

Addresses

Primary practice location

1400 US Highway 61
Festus, MO 63028-4100

Mailing address

1400 US Highway 61
Festus, MO 63028-4100
Phone (636) 933-5337

Other practice location 1

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6339

Other practice location 2

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1328

Other practice location 3

901 E 5th St
Washington, MO 63090-3127
Phone (636) 239-8231

Other identifiers 1

IdentifierTypeStateIssuer
214881OtherILGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 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
I20180809005638 IL Practitioner - HospitalistPractitioner - Internal Medicine 8729336565 Reassigns benefits to 1 organization
I20221013002976 MO Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8729336565 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Adult Hospitalists Jefferson LLCGroup PAC ID 8628205598, 58 clinicians

Practice addresses (Care Compare)

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-8091

Hospital & facility affiliations

  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Oct 10, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Oct 10, 2022 Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC CurrentSince Oct 10, 2022 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Oct 10, 2022 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. Hospitalist CurrentSince Oct 10, 2022 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Aug 27, 2018 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC Hospitalist CurrentSince Oct 10, 2022 Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

201 S 14th St
#Sih
Herrin, IL 62948
Phone 6189422171 ext. 65137

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

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 3

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": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1811320856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-5337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 S New Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418221",
            "country_code": "US",
            "telephone_number": "314-251-6339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630903127",
            "country_code": "US",
            "telephone_number": "636-239-8231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLEKAR",
        "first_name": "CHARU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036146491",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036146491",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2022037561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.