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

Mr. Nikolai McKoy, CAA

Individual provider Anesthesiologist Assistant · NPI 1104448059

Mr. Nikolai McKoy, CAA is an Anesthesiology Assistant in Saint Louis, Missouri. Qualified in 2020, 6 years ago. Practices with Mak Anesthesia Holdings, LLC, a 368-clinician group.

Years since qualifying
6
In the registry since
2020
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Practice location Address checks out

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone: (636) 386-9224
Fax: (636) 386-7679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1104448059
Entity typeIndividual (Type 1)
GenderMale
Credentials CAA
Sole proprietorNo
NPI enumeratedMay 14, 2020
Last updated in NPPESAugust 19, 2020
Certification dateAugust 19, 2020

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Mak Anesthesia Holdings, Llc — 368 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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