Active NPI
Kyle Patrick McLafferty, PA
- Medical Physician Assistant
- Saint Louis, MO
National Provider Identifier
1831675545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2018025495
- Practice address
- 11133 Dunn Rd
Dept Anesthesiology
Saint Louis, MO 63136-6163 - Phone
- (800) 862-9980
- Fax
- (314) 362-1185
- NPI assigned
- Jul 16, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2018025495 | MO | Primary |
Addresses
Primary practice location
11133 Dunn Rd
Dept Anesthesiology
Saint Louis, MO 63136-6163
Mailing address
660 S Euclid Ave
CB 8054
Saint Louis, MO 63110-1010
Phone (800) 862-9980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220061872 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2023 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1831675545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "CB 8054",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11133 DUNN RD",
"address_2": "DEPT ANESTHESIOLOGY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366163",
"telephone_number": "800-862-9980",
"fax_number": "314-362-1185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLAFFERTY",
"first_name": "KYLE",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-16",
"last_updated": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MO",
"license": "2018025495",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220061872",
"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": "11133 Dunn Rd",
"address_2": "Dept Anesthesiology",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631366163",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.