Individual provider Active NPI

Marketa Kasalova, M.D.

  • Internal Medicine Physician
  • Hazelwood, MO
National Provider Identifier
1922200617
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2007010298 Issued in MO
Practice address
755 Dunn Rd
Ste 110
Hazelwood, MO 63042-1751
Phone
(314) 731-4222
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2007010298 MO Primary

Addresses

Primary practice location

755 Dunn Rd
Ste 110
Hazelwood, MO 63042-1751

Mailing address

9966 Conway Rd
Saint Louis, MO 63124-1671
Phone (314) 567-1700

Other identifiers 1

IdentifierTypeStateIssuer
P00658454OtherMORAILROAD MEDICARE

Other names 1

  • Marketa Kocnova 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
I20070703000611 MO Practitioner - Internal Medicine 8426158403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

755 Dunn Rd
Suite 110
Hazelwood, MO 63042-1753
Phone (314) 731-1113

755 Dunn Rd
Suite 130
Hazelwood, MO 63042-1751
Phone (314) 872-9192

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
  • Amedisys Home Health of Missouri Home health agency, Hillsboro, MO, CCN 267270
  • Mercy Hospice Hospice, Saint Louis, MO, CCN 261510
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007010298MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Feb 8, 2011 Accepting new patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jul 2, 2007 Accepting new patients
Mercy Hospitals East Communities CurrentSince Feb 8, 2011 Accepting new patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jul 2, 2007 Accepting new patients
Cravens Medical Center, PLLC Past Accepting new patients
Sunshine Specialty Clinic, PLLC Past Accepting new patients
Plateau Medical Group PC Past Accepting new patients

Locations

755 Dunn Rd
Ste 110
Hazelwood, MO 63042
Phone (314) 731-1113

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Interoperability endpoints

  • Direct secure messaging: mkasalova259@directc.mercy.net
  • FHIR API: https://api.platform.athenahealth.com/1572/brand/1/csg/81/fhir/r4

Organizations & group practices 7

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 6

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1922200617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9966 CONWAY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241671",
            "telephone_number": "314-567-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 DUNN RD",
            "address_2": "STE 110",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421751",
            "telephone_number": "314-731-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASALOVA",
        "first_name": "MARKETA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007010298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00658454",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARKETA",
            "last_name": "KOCNOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hazelwood, MO

Sources for this page

Verify at the official NPI Registry.