Individual provider Active NPI

Kenneth Richard Rohrbach Jr., PA-C

  • Medical Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1912247123
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2013005306 Issued in MO
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-7033
NPI assigned
Feb 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2013005306 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 610-3682

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130927000387 MO Practitioner - Physician Assistant 6800020116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians
St Louis Kidney LLCGroup PAC ID 0143446617, 9 clinicians

Practice addresses (Care Compare)

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

456 N New Ballas Rd
Suite 348
Creve Coeur, MO 63141-6846
Phone (314) 548-0265

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2013005306MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Pathology Group, Inc. Current Accepting new patients
Missouri Baptist Medical Center CurrentSince Jul 17, 2013 Accepting new patients
Missouri Baptist Medical Center CurrentSince Jul 17, 2013 Accepting new patients

Locations

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

456 N New Ballas Rd
Ste 348
Saint Louis, MO 63141
Phone (314) 548-0265

800 Ste Genevieve Dr
Ste Genevieve, MO 63670
Phone (573) 883-2571

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1912247123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-610-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHRBACH",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-25",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2013005306",
            "primary": true
        }
    ],
    "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": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.