MR. NIKOLAI MCKOY CAA
NPI 1104448059
Anesthesiologist Assistant in Saint Louis, MO

Q: What is Nikolai Mckoy's NPI number?

The NPI number for Nikolai Mckoy is 1104448059. It was assigned to this individual provider in the NPPES registry on May 14, 2020.

Q: What is Nikolai Mckoy's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Nikolai Mckoy was last updated on August 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 14, 2020

80.25/100

CMS Quality Rating

615 S NEW BALLAS RD, SAINT LOUIS, MO 63141(636) 386-9224(636) 386-7679 Get Directions Write a Review

NPPES record last updated: August 19, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 19, 2020, May 14, 2020 (2 updates tracked since 2020).

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About Mr. Nikolai Mckoy Caa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. NIKOLAI MCKOY CAA (NPI 1104448059) is an individual anesthesiologist assistant in Saint Louis, Missouri and active in the NPI registry since May 2020. He is affiliated with Adventhealth Orlando and is a graduate of Other (2020).

NPPES Registry Identity

NPI1104448059

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameMR. NIKOLAI MCKOYCredential: CAA

Location Address615 S NEW BALLAS RDSaint Louis, MO 63141-8221

Mailing Address339 Consort DrBallwin, MO 63011-4439 · (636) 386-9224 · Fax (636) 386-7679

Phone(636) 386-9224

Fax(636) 386-7679

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMay 14, 2020

Last NPPES UpdateAugust 19, 20202 updates tracked since enumeration

NPPES CertifiedAugust 19, 2020

✔ NPI 1104448059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

615 S NEW BALLAS RD, Saint Louis, MO 63141

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Nikolai Mckoy Caa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2567881204

PECOS Enrollment IDI20210126000739, I20250723004119

Medicare Billing Reassignments

Medicare enrollment records show Nikolai Mckoy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mak Anesthesia Holdings LLC

459 mi

Anesthesiology

1300 RIDENOUR BLVD NW STE 300
Kennesaw, GA 30152

Reassigned Medicare billing, Georgia enrollment
629 clinicians in this Medicare group

NPI 1912452939 (770) 702-1806

Us Anesthesia Partners Of Florida Inc.

865 mi

Anesthesiology

851 TRAFALGAR CT, SUITE 200E
Maitland, FL 32751

Reassigned Medicare billing, Florida enrollment
2,356 clinicians in this Medicare group

NPI 1518910520 (321) 422-7155

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

37 services36 patients

Anesthesia for procedure to assess heart electrical activity 00537

Anesthesia for a procedure to assess heart electrical activity helps ensure comfort and relaxation. It involves administering medication that either numbs a specific area or makes you sleep temporarily. This allows doctors to safely examine your heart's electrical signals without causing discomfort.

19 services19 patients

Anesthesia for procedure on gallbladder, pancreas, or liver using an endoscope 00732

This procedure involves using an endoscope, a flexible tube with a light and camera, to examine or treat your gallbladder, pancreas, or liver. Anesthesia is administered to ensure you're comfortable and pain-free during the procedure.

18 services18 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100007

Location601 E Rollins StOrlando, FL 32803 · Orange County

Emergency services Birthing friendly

Wellstar North Fulton Hospital

Acute Care Hospitals · Roswell, GA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number110198

Location3000 Hospital BoulevardRoswell, GA 30076 · Fulton County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.25/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

83.44

Improvement Activities

Cost

64.53

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. PATRICIA ANN RICE APN

Nurse Practitioner (Family)

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 251-6339

MARY BETH WALKER FNP

Nurse Practitioner (Family)

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 251-6000

LOVEPREET SINGH RANDHAWA MD

Internal Medicine

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 251-6339

DR. CONNOR ROBERT REIS DO

Internal Medicine

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 251-6930

MR. SHEBY THOMAS AA-S

Anesthesiologist Assistant

615 S NEW BALLAS RD, DEPT OF ANESTHESIOLOGY
SAINT LOUIS, MO 63141

St. Louis County (636) 386-9224

JOSE L OLIVER SEGARRA

Dentist

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 251-6382

CAREN BIRKENKAMP PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 251-6000

ANAS M HASIC MD

Internal Medicine

615 S NEW BALLAS RD
SAINT LOUIS, MO 63141

St. Louis County (314) 509-5305

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nikolai Mckoy's NPI number?

The NPI number for Nikolai Mckoy is 1104448059. It was assigned to this individual provider in the NPPES registry on May 14, 2020.

Where is Nikolai Mckoy located?

Nikolai Mckoy practices at 615 S New Ballas Rd, Saint Louis, MO 63141. The listed phone number is (636) 386-9224.

What is Nikolai Mckoy's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Nikolai Mckoy enrolled in Medicare?

Yes. Nikolai Mckoy is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nikolai Mckoy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nikolai Mckoy reassigns Medicare benefits to 2 organizations: Mak Anesthesia Holdings LLC (Kennesaw, GA) and Us Anesthesia Partners Of Florida Inc. (Maitland, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nikolai Mckoy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Nikolai Mckoy affiliated with any hospitals?

According to CMS data, Nikolai Mckoy is affiliated with Adventhealth Orlando and Wellstar North Fulton Hospital.

When was this NPI record last updated?

The NPPES record for Nikolai Mckoy was last updated on August 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.