Individual provider Active NPI

Gary David Koenig, M.D.

  • Gastroenterology Physician
  • Hazelwood, MO
National Provider Identifier
1861485724
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MDR3G44 Issued in MO
Practice address
100 Village SQ
Hazelwood, MO 63042-1820
Phone
(314) 355-4010
Fax
(314) 355-9484
NPI assigned
Aug 25, 2005
Last updated
Feb 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MDR3G44 MO Primary
Gastroenterology Physician 207RG0100X RG344 MO

Addresses

Primary practice location

100 Village SQ
Hazelwood, MO 63042-1820

Mailing address

PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 355-4010

Other practice location 1

20 Progress Point Pkwy Ste 206
O Fallon, MO 63368-2207
Phone (636) 344-1073

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090803000025 MO Practitioner - GastroenterologyPractitioner - Internal Medicine 9335169887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Saint Louis University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians
Mercy Clinic Gastroenterology LLCGroup PAC ID 8628121795, 66 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Suite 100
Saint Peters, MO 63376-1659
Phone (636) 916-7272

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

901 Patients 1St Dr
Suite 3300
Washington, MO 63090-4700
Phone (636) 239-7344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.37 of 100Reported as group
Quality
79.66
Promoting interoperability
98
Improvement activities
40
Cost
76.57

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy58
Upper gastrointestinal (GI) endoscopy for acid reflux52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR3G44MOMDGastroenterology Physician
RG344MOMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Gastroenterology CurrentSince Mar 1, 2026 Accepting new patients
Physician Groups LC CurrentSince Mar 1, 2026 Accepting new patients
Mercy Clinic Gastroenterology, LLC Gastroenterology CurrentSince Jan 13, 2026 Accepting new patients

Locations

200 Brevco Plz
Ste 208
Lake St Louis, MO 63367
Phone (314) 251-3880

20 Progress Point Pkwy
Ste 206
O Fallon, MO 63368
Phone (636) 344-1073

901 Patients First Dr
Ste 3300
Washington, MO 63090
Phone (636) 231-6044

Interoperability endpoints

  • Direct secure messaging: gary.koenig.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1861485724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-355-4010",
            "fax_number": "314-355-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VILLAGE SQ",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421820",
            "telephone_number": "314-355-4010",
            "fax_number": "314-355-9484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Progress Point Pkwy Ste 206",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633682207",
            "country_code": "US",
            "telephone_number": "636-344-1073",
            "fax_number": "636-916-9953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "GARY",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "MDR3G44",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "RG344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20 Progress Point Pkwy Ste 206",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633682207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

Verify at the official NPI Registry.