Mr Kristopher Vaughn Pullam, MD - Medicare Family Practice in Fenton, MO

Mr Kristopher Vaughn Pullam, MD is a medicare enrolled "Family Medicine" physician in Fenton, Missouri. He graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Mercy Clinic East Communities and his current practice location is 1203 Smizer Mill Rd Ste 105, Fenton, Missouri. You can reach out to his office (for appointments etc.) via phone at (636) 717-1350.

Mr Kristopher Vaughn Pullam is licensed to practice in Missouri (license number 2021019546) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1679067276.

Contact Information

Mr Kristopher Vaughn Pullam, MD
1203 Smizer Mill Rd Ste 105,
Fenton, MO 63026-3483
(636) 717-1350
Not Available



Physician's Profile

Full NameMr Kristopher Vaughn Pullam
GenderMale
SpecialityFamily Practice
Experience6 Years
Location1203 Smizer Mill Rd Ste 105, Fenton, Missouri
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Kristopher Vaughn Pullam graduated from medical school in 2018
  NPI Data:
  • NPI Number: 1679067276
  • Provider Enumeration Date: 06/18/2018
  • Last Update Date: 06/08/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3678822269
  • Enrollment ID: I20211020002439

Medical Identifiers

Medical identifiers for Mr Kristopher Vaughn Pullam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679067276NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 2021019546 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Mercy Hospital St LouisSaint louis, MOHospital
Mercy Hospital WashingtonWashington, MOHospital
Mercy Hospital SouthSaint louis, MOHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mercy Clinic East Communities7214827922491

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Kristopher Vaughn Pullam allows following entities to bill medicare on his behalf.
Entity NameMercy Clinic East Communities
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851335228
PECOS PAC ID: 7214827922
Enrollment ID: O20070521000006

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kristopher Vaughn Pullam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Kristopher Vaughn Pullam, MD
1203 Smizer Mill Rd Ste 105,
Fenton, MO 63026-3483

Ph: (636) 717-1350
Mr Kristopher Vaughn Pullam, MD
1203 Smizer Mill Rd Ste 105,
Fenton, MO 63026-3483

Ph: (636) 717-1350

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Family Medicine Doctors in Fenton, MO

Susan J. Davis, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1345 Smizer Mill Rd Ste 1100, Fenton, MO 63026
Phone: 636-496-5023    
Sarah Ludlow, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1345 Smizer Mill Rd Ste 1100, Fenton, MO 63026
Phone: 636-496-5022    
Dr. John Martin Crowe Jr., M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1670 Fenpark Dr, Fenton, MO 63026
Phone: 636-492-6376    Fax: 636-326-6557
Dr. Melissa Ann Muench, D.O.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 714 Gravois Rd Ste 210, Fenton, MO 63026
Phone: 636-660-9850    Fax: 636-660-9851
Dr. Justin E. Hugo, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 714 Gravois Rd, Suite 210, Fenton, MO 63026
Phone: 314-543-5230    Fax: 314-543-5280
Mr. Christopher Paul Friesen, DO
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 320 Gravois Rd, Suite B, Fenton, MO 63026
Phone: 636-305-1899    Fax: 636-305-1898
Brenda Lynn Buckley, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1747 Smizer Station Rd, Suite 5, Fenton, MO 63026
Phone: 636-529-7000    Fax: 636-529-7003

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