MR. KRISTOPHER VAUGHN PULLAM MD
NPI 1679067276
Family Medicine in Fenton, MO

Active since June 18, 2018PECOS EnrolledAccepts Medicare Assignment
1203 SMIZER MILL RD STE 105, FENTON, MO 63026(636) 717-1350 Get Directions Write a Review

NPPES record last updated: June 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 8, 2021, Jun 18, 2018 (2 updates tracked since 2018).

About Mr. Kristopher Vaughn Pullam Md NPPES

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

MR. KRISTOPHER VAUGHN PULLAM MD (NPI 1679067276) is an individual family medicine provider in Fenton, Missouri, licensed in Missouri (2021019546) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1679067276
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. KRISTOPHER VAUGHN PULLAMCredential: MD
Location Address1203 SMIZER MILL RD STE 105Fenton, MO 63026-3483
Mailing Address1203 Smizer Mill Rd Ste 105Fenton, MO 63026-3483 · (636) 717-1350 · Fax (314) 251-8889
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateJune 18, 2018
Last NPPES UpdateJune 8, 20212 updates tracked since enumeration
NPPES CertifiedJune 8, 2021
NPI 1679067276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in MO · 2021019546
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1203 SMIZER MILL RD STE 105, Fenton, MO 63026

Secondary Practice Location 1

Location 1621 S New Ballas RdSaint Louis, MO 63141-8232 · Phone (314) 251-8888 · Fax (314) 251-8889

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

Mr. Kristopher Vaughn Pullam Md 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 ID3678822269
PECOS Enrollment IDI20211020002439
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 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
196 services104 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
73 services73 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
19 services19 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
17 services17 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
17 services14 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
15 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260020
Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County
Emergency services Birthing friendly

Mercy Hospital Jefferson

Acute Care Hospitals · Festus, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260023
Location1400 Us Highway 61Festus, MO 63028 · Jefferson County
Emergency services

Mercy Hospital Washington

Acute Care Hospitals · Washington, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260052
Location901 East 5th StreetWashington, MO 63090 · Franklin County
Emergency services

Mercy Hospital South

Acute Care Hospitals · Saint Louis, MO
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260077
Location10010 Kennerly RoadSaint Louis, MO 63128 · St. Louis County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63026 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.

Referred Medical Equipment & Supplies CMS DME claims

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier19 claims19 services$69.66 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 2

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

Family Medicine (Adult Medicine)
1203 SMIZER MILL RD STE 105
FENTON, MO 63026
Family Medicine
1203 SMIZER MILL RD STE 105
FENTON, MO 63026

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 Kristopher Pullam's NPI number?

The NPI number for Kristopher Pullam is 1679067276. It was assigned to this individual provider in the NPPES registry on June 18, 2018.

Where is Kristopher Pullam located?

Kristopher Pullam practices at 1203 Smizer Mill Rd Ste 105, Fenton, MO 63026. The listed phone number is (636) 717-1350.

What is Kristopher Pullam's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kristopher Pullam enrolled in Medicare?

Yes. Kristopher Pullam 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 Kristopher Pullam accept?

Health plans from Medica and UnitedHealthcare list Kristopher Pullam 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 Kristopher Pullam affiliated with any hospitals?

According to CMS data, Kristopher Pullam is affiliated with Mercy Hospital St Louis, Mercy Hospital Jefferson, Mercy Hospital Washington and Mercy Hospital South.

When was this NPI record last updated?

The NPPES record for Kristopher Pullam was last updated on June 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.