NPIMap

Individual provider Active NPI

Olexandr Sergeyevich Krinochkin, MD

  • Internal Medicine Physician
  • Springfield, MO
National Provider Identifier
1912971318
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2005019902 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-6569
Fax
(417) 820-6720
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MED-PHYS-LIC-102786 MT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2005019902 MO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036147482 IL
Internal Medicine Physician 207R00000X 2005019902 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other practice location 1

350 Heritage Way Ste 2100
Kalispell, MT 59901-3167
Phone (406) 257-8992

Other practice location 2

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone (847) 437-5500

Other identifiers 4

IdentifierTypeStateIssuer
1912971318MedicaidMO
188251001MedicaidAR
431560263OtherMNTRICARE
P00954935OtherMORR MCR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address DEPTLHRevIntegrityHIMTechs@logan.org Kalispell Regional Medical Center Inc
Direct Messaging Address okrinochkin852616@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TN, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060306000274 MO Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8527074129 Reassigns benefits to 3 organizations
I20171201002028 TN Practitioner - HospitalistPractitioner - Internal Medicine 8527074129 Reassigns benefits to 1 organization
I20241231000799 MN Practitioner - Critical Care (Intensivists) 8527074129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-102786MTMDInternal Medicine Physician
2005019902MOMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Select Specialty Hospital Springfield Inc CurrentSince May 25, 2015 Accepting new patients
Centracare Clinic CurrentSince Dec 23, 2024 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Nov 7, 2017 Accepting new patients
Centracare Clinic Current Accepting new patients
Wellmont Medical Associates Inc Internal Medicine Current Accepting new patients
Cogent Healthcare of Missouri, Inc Critical Care Medicine CurrentSince Jul 15, 2017 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Nov 7, 2017 Accepting new patients
Centracare Clinic CurrentSince Dec 23, 2024 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Our Urgent Care, LLC PastSince Dec 9, 2019 Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

1630 E Primrose St
Springfield, MO 65804
Phone (417) 885-4700

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

Interoperability endpoints

  • Direct secure messaging: olexandrkrinochkin@sfc.allscriptsdirect.net

Organizations & group practices 12

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 8

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1912971318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-6569",
            "fax_number": "417-820-6720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Heritage Way Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-257-8992",
            "fax_number": "406-257-8996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Biesterfield Rd",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600073361",
            "country_code": "US",
            "telephone_number": "847-437-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRINOCHKIN",
        "first_name": "OLEXANDR",
        "middle_name": "SERGEYEVICH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-102786",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2005019902",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036147482",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2005019902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912971318",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188251001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00954935",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHRevIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "350 Heritage Way Ste 2100",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okrinochkin852616@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "okrinochkin852616@direct.centracare.com",
            "address_1": "1200 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563032735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.