Jacob T Ark, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

36145240 Issued in IL

Practice address

12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657

Phone

(314) 567-6071

NPI assigned

Apr 28, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Urology

Education

Vanderbilt University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS St Elizabeth's Hospital Hospital, O Fallon, IL, CCN 140187
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• St Josephs Hospital Hospital, Breese, IL, CCN 140145
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jark@yourcarecommunity.org
• Direct secure messaging: jacobark@slus.allscriptsdirect.net

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.

• Urology of St. Louis, Inc.

  dba Neurosurgery of St Louis

  • Specialist
  • Saint Louis, MO
  • NPI 1528017191

  IL, Urology

  Medicare reassignment Care Compare group NPD
• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Urology of St. Louis, Inc.

  dba Neurosurgery of St Louis

  • Specialist
  • O'Fallon, IL
  • NPI 1265392476
  NPD
• Urology of St. Louis, Inc.

  • Urology Physician
  • Fairview Heights, IL
  • NPI 1528901287
  NPD (past)

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

• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  dba HSHS St. Elizabeth's Hospital

  • General Acute Care Hospital
  • O'Fallon, IL
  • NPI 1629057302
  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  dba Clinton County Rural Health

  • Rural Health Clinic/Center
  • Breese, IL
  • NPI 1013002658

  Hospital

  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  dba St. Joseph's Hospital

  • General Acute Care Hospital
  • Breese, IL
  • NPI 1457319154
  Care Compare affiliation

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

{
    "created_epoch": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1891053716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-567-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-567-6071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 Fountains Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622082041",
            "country_code": "US",
            "telephone_number": "618-489-8030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARK",
        "first_name": "JACOB",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-28",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2018009509",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "36145240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "Y",
            "endpointDescription": "bjc",
            "affiliationName": "Missouri Baptist Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12855 N 40 Dr Ste 375",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Della Louise Aridge, RN, MSN, NP
• Geniveb Ariosa
• Allison Aripoli, MD
• Shirley Ariwodo, MD
• Arj Infusion Services, LLC (Arj Infusion Services)
• Arkansas Health & Wellness Health Plan, Inc.
• Arkila 360 Degrees Counseling and Consulting Services (360 Degrees Counseling and Consulting Services)
• Te'Ara Arman
• Irene Armas
• Daniel Gerard Armbruster, DC

• Urology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Urology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.