Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bradley William Petkovich, MD

Individual provider Internal Medicine Physician · NPI 1033485156

Bradley William Petkovich, MD is a Pulmonary Disease in Saint Louis, Missouri. Qualified in 2012, 14 years ago. Practices with SSM Medical Group Inc, a 560-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Missouri.

Years since qualifying
14
Licensed in
MO
In the registry since
2012
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone: (314) 768-8622
Fax: (314) 768-7177
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1035 Bellevue Ave Ste 500, Saint Louis, MO 63117-1843 — (314) 925-4744

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 2025038953 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2025038953 (MO)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 2025038953 (MO)

Record details

NPI number1033485156
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2012
Last updated in NPPESMarch 17, 2026
Certification dateMarch 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPULMONARY DISEASE
Also practisesCRITICAL CARE (INTENSIVISTS)
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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