NPIMap

Individual provider Active NPI

Philip Fish, M.D.

  • Urology Physician
  • Columbia, MO
National Provider Identifier
1841782307
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2023012283 Issued in MO
Practice address
105 N Keene St Ste 201
Columbia, MO 65201-8131
Phone
(573) 499-4990
Fax
(573) 442-2120
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2023012283 MO Primary

Addresses

Primary practice location

105 N Keene St Ste 201
Columbia, MO 65201-8131

Mailing address

105 N Keene St Ste 201
Columbia, MO 65201-8131
Phone (573) 499-4990

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address philip.fish@mca.ikm.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230609003003 MO Practitioner - Urology 1456718261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Oklahoma College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Cancer Associates LLCGroup PAC ID 8729975305, 22 clinicians

Practice addresses (Care Compare)

105 N Keene St
201 Urology Associates of Central Missouri
Columbia, MO 65201-8401
Phone (573) 499-4990

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023012283MOMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Cancer Associates LLC CurrentSince Aug 1, 2023 Accepting new patients
Missouri Cancer Associates LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

2372 Paysphere Cir
Chicago, IL 60674

105 N Keene St
Ste 201
Columbia, MO 65201
Phone (573) 499-4990

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 100
Columbia, MO 65201
Phone (573) 874-7800

305 N Keene St
Ste 107
Columbia, MO 65201
Phone (573) 239-3310

Interoperability endpoints

  • Direct secure messaging: philip.fish@mca.ikm.direct-ci.com

Organizations & group practices 2

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1841782307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 201",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-499-4990",
            "fax_number": "573-442-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 201",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-499-4990",
            "fax_number": "573-442-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "PHILIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2023012283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.fish@mca.ikm.direct-ci.com",
            "affiliation": "N",
            "address_1": "105 N Keene St Ste 201",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652018131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.