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ROBERT K GAUGHAN M.D.
NPI 1720076987
Otolaryngology in Saint Louis, MO

Active since October 12, 2005PECOS Enrolled
12399 GRAVOIS RD, SUITE 120, SAINT LOUIS, MO 63127(314) 843-3828(314) 843-3052 Get Directions Write a Review

NPPES record last updated: April 23, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Robert K Gaughan M.d. NPPES

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

ROBERT K GAUGHAN M.D. (NPI 1720076987) is an individual otolaryngology provider in Saint Louis, Missouri, licensed in Missouri (100201) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720076987
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameROBERT K GAUGHANCredential: M.D.
Location Address12399 GRAVOIS RD, SUITE 120Saint Louis, MO 63127-1750
Mailing Address9701 Landmark Parkway Dr, Ste 201Saint Louis, MO 63127-1665 · (314) 843-3828 · Fax (314) 843-3052
Phone(314) 843-3828
Fax(314) 843-3052
Sole ProprietorNo
Enumeration DateOctober 12, 2005
Last NPPES UpdateApril 23, 2020
NPPES CertifiedApril 23, 2020
✔ NPI 1720076987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in MO · 100201
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
12399 GRAVOIS RD, Saint Louis, MO 63127
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert K Gaughan M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Robert Gaughan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mercy Hospitals East Communities
10 mi
Clinic/Center
615 S NEW BALLAS RD
Saint Louis, MO 63141
  • Reassigned Medicare billing, Missouri enrollment
  • 435 clinicians in this Medicare group
NPI 1851431738 (314) 251-6382

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 5

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.
93 services71 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.
87 services72 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
53 services53 patients
Comprehensive hearing and speech recognition test 92557
A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.
52 services52 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
23 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63127 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
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
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.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers12 claims12 services$29.14 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 6

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

MARK F STROBLE M.D.
Otolaryngology
12399 GRAVOIS RD, STE 120
SAINT LOUIS, MO 63127
St. Louis County (314) 843-3828
SUNSET HILLS IMAGING, LLC
Specialist
12399 GRAVOIS RD
SAINT LOUIS, MO 63127
St. Louis County (314) 729-7243
ADVANTICA ADMINISTRATIVE SERVICES, INC.
Preferred Provider Organization
12399 GRAVOIS RD, 2ND FLOOR
SAINT LOUIS, MO 63127
St. Louis County (314) 543-4900
WEBSTER AMBULATORY SUGERY CENTER LP
Clinic/Center (Ambulatory Surgical)
12399 GRAVOIS RD, SUITE 102
SAINT LOUIS, MO 63127
St. Louis County (314) 729-0100
SUNSET HILLS AMBULATORY SURGERY CENTER LP
Clinic/Center (Ambulatory Surgical)
12399 GRAVOIS RD, STE 102
SAINT LOUIS, MO 63127
St. Louis County (314) 729-0100
RICHARD E SCHRICK M.D.
Otolaryngology
12399 GRAVOIS RD, SUITE 120
SAINT LOUIS, MO 63127
St. Louis County (314) 843-3828

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 Robert Gaughan's NPI number?

The NPI number for Robert Gaughan is 1720076987. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Robert Gaughan located?

Robert Gaughan practices at 12399 Gravois Rd Suite 120, Saint Louis, MO 63127. The listed phone number is (314) 843-3828.

What is Robert Gaughan's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Robert Gaughan enrolled in Medicare?

Yes. Robert Gaughan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Robert Gaughan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Gaughan reassigns Medicare benefits to Mercy Hospitals East Communities (Saint Louis, MO). The 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 Robert Gaughan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Robert Gaughan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer list Robert Gaughan 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.

When was this NPI record last updated?

The NPPES record for Robert Gaughan was last updated on April 23, 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.