Individual provider Active NPI

Agnes M Laus, MD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1881670974
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2024044616 Issued in MO
Practice address
12680 Olive Blvd Ste 116
Saint Louis, MO 63141-6322
Phone
(314) 529-5660
Fax
(314) 529-5665
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35070728L OH
Pediatrics Physician 208000000X 2024044616 MO Primary

Addresses

Primary practice location

12680 Olive Blvd Ste 116
Saint Louis, MO 63141-6322

Mailing address

12680 Olive Blvd Ste 116
Saint Louis, MO 63141-6322
Phone (314) 529-5660

Other identifiers 3

IdentifierTypeStateIssuer
0273396MedicaidOH
510450201027OtherCARESOURCE
000000323677OtherANTHEM

Other names 1

  • Agnes Magno Former name

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
I20250414000341 MO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9638081854

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35070728LOHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Mercy Childrens Therapy and Development LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alaus19108@copcp.medicity.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1881670974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD STE 116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-529-5660",
            "fax_number": "314-529-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD STE 116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-529-5660",
            "fax_number": "314-529-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUS",
        "first_name": "AGNES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35070728L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2024044616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0273396",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "510450201027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000323677",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "MAGNO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.