Individual provider Active NPI

Elysha M Kachevas

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1023447539
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013041945 Issued in MO
Practice address
11133 Dunn Rd
Suite 2335
Saint Louis, MO 63136-6119
Phone
(314) 653-5007
Fax
(314) 653-4149
NPI assigned
Nov 5, 2013
Last updated
Nov 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2013041945 MO Primary

Addresses

Primary practice location

11133 Dunn Rd
Suite 2335
Saint Louis, MO 63136-6119

Mailing address

11133 Dunn Rd
Suite 2335
Saint Louis, MO 63136-6119
Phone (314) 653-5007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140325001625 MO Practitioner - Nurse Practitioner 4082845615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary Consultants IncGroup PAC ID 1355317280, 10 clinicians

Practice addresses (Care Compare)

300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone (636) 443-2661

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5160

6 Jungermann Cir
Suite 210
Saint Peters, MO 63376-1625
Phone (636) 441-6056

Merit-based Incentive Payment System (MIPS)

Final score
85.46 of 100Reported as group
Quality
63.46
Improvement activities
40
Cost
83.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013041945MOMDFamily Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1023447539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "SUITE 2335",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366119",
            "telephone_number": "314-653-5007",
            "fax_number": "314-653-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "SUITE 2335",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366119",
            "telephone_number": "314-653-5007",
            "fax_number": "314-653-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACHEVAS",
        "first_name": "ELYSHA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013041945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.