MRS. KONGKEO THIKY WALTHER ANP
NPI 1528433430
Nurse Practitioner - Acute Care in Bridgeton, MO

Active since December 03, 2015PECOS EnrolledAccepts Medicare Assignment
79.29/100
CMS Quality Rating
12774 BOENKER LN, BRIDGETON, MO 63044(314) 291-7997(314) 739-1471 Get Directions Write a Review

NPPES record last updated: December 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Nov 15, 2021, Nov 12, 2021 and 2 more (5 updates tracked since 2015).

About Mrs. Kongkeo Thiky Walther Anp NPPES

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

MRS. KONGKEO THIKY WALTHER ANP (NPI 1528433430) is an individual acute care provider in Bridgeton, Missouri, licensed in Missouri (2015040094) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS, is affiliated with Ssm Health Depaul Hospital St Louis, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1528433430
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMRS. KONGKEO THIKY WALTHERCredential: ANP
Location Address12774 BOENKER LNBridgeton, MO 63044-2436
Mailing AddressPo Box 776874Chicago, IL 60677-6874 · (314) 291-7997 · Fax (314) 739-1471
Fax(314) 739-1471
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateDecember 3, 2015
Last NPPES UpdateDecember 21, 20235 updates tracked since enumeration
NPPES CertifiedOctober 5, 2022
NPI 1528433430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License Licensed in MO · 2015040094
12774 BOENKER LN, Bridgeton, MO 63044

Other Names 1

Former Name (1)Kongkeo Thiky Vorachack

Secondary Practice Location 1

Location 14921 Parkview Pl, Div Surg Urology, Ste 11CSaint Louis, MO 63110-1032 · Phone (314) 362-8200 · Fax (314) 454-5244

Other Identifiers 1

Medicaid420030952MO

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mrs. Kongkeo Thiky Walther Anp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618275041
PECOS Enrollment IDI20160418001742
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
844 services294 patients

Hospital Affiliations CMS Care Compare 4

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

Ssm Health Depaul Hospital St Louis

Acute Care Hospitals · Bridgeton, MO
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number260104
Location12303 Depaul DriveBridgeton, MO 63044 · St. Louis County
Emergency services Birthing friendly

Missouri Baptist Medical Center

Acute Care Hospitals · Town And Country, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260108
Location3015 N Ballas RdTown And Country, MO 63131 · St. Louis County
Emergency services Birthing friendly

Christian Hospital Northeast

Acute Care Hospitals · Saint Louis, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260180
Location11133 Dunn RoadSaint Louis, MO 63136 · St. Louis County
Emergency services

Barnes-Jewish St Peters Hospital

Acute Care Hospitals · Saint Peters, MO
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260191
Location10 Hospital DrSaint Peters, MO 63376 · St. Charles County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63044 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

79.29/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.46
Promoting Interoperability100
Improvement Activities40
Cost59.51

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332
DME-Medical/Surgical Supplies · category DA000N
5 suppliers43 claims6,250 services$0.10 avg. paid by Medicare
Male external catheter, with or without adhesive, disposable, each A4349
DME-Medical/Surgical Supplies · category DA000N
2 suppliers13 claims575 services$1.93 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
8 suppliers150 claims19,390 services$1.63 avg. paid by Medicare
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
5 suppliers27 claims5,770 services$5.78 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
6 suppliers20 claims72 services$9.35 avg. paid by Medicare
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each A4430
DME-Orthotic Devices · category DF010N
1 supplier17 claims285 services$7.77 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

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

Internal Medicine (Infectious Disease)
12774 BOENKER LN
BRIDGETON, MO 63044
Nurse Practitioner
12774 BOENKER LN
BRIDGETON, MO 63044
Internal Medicine (Infectious Disease)
12774 BOENKER LN
BRIDGETON, MO 63044
Nurse Practitioner (Family)
12774 BOENKER LN
BRIDGETON, MO 63044
Internal Medicine (Infectious Disease)
12774 BOENKER LN
BRIDGETON, MO 63044
Internal Medicine (Infectious Disease)
12774 BOENKER LN
BRIDGETON, MO 63044
Internal Medicine (Infectious Disease)
12774 BOENKER LN
BRIDGETON, MO 63044
Nurse Practitioner (Gerontology)
12774 BOENKER LN
BRIDGETON, MO 63044

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 Kongkeo Walther's NPI number?

The NPI number for Kongkeo Walther is 1528433430. It was assigned to this individual provider in the NPPES registry on December 3, 2015. The provider is also known as Kongkeo Thiky Vorachack.

Where is Kongkeo Walther located?

Kongkeo Walther practices at 12774 Boenker Ln, Bridgeton, MO 63044. The listed phone number is (314) 291-7997.

What is Kongkeo Walther's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Kongkeo Walther enrolled in Medicare?

Yes. Kongkeo Walther is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kongkeo Walther accept?

Health plans from Oscar Insurance Company list Kongkeo Walther as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kongkeo Walther affiliated with any hospitals?

According to CMS data, Kongkeo Walther is affiliated with Ssm Health Depaul Hospital St Louis, Missouri Baptist Medical Center, Christian Hospital Northeast and Barnes-Jewish St Peters Hospital.

When was this NPI record last updated?

The NPPES record for Kongkeo Walther was last updated on December 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.