Individual provider Active NPI

Trista Kostello, NP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1043038334
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024043059 Issued in MO
Practice address
701 S New Ballas Rd Ste 510
Saint Louis, MO 63141-8726
Phone
(314) 251-6710
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2015022116 MO
Family Nurse Practitioner 363LF0000X 2024043059 MO Primary

Addresses

Primary practice location

701 S New Ballas Rd Ste 510
Saint Louis, MO 63141-8726

Mailing address

572 Spragues Mill CT
Ballwin, MO 63011-3327
Phone (636) 751-4336

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
I20241211004273 MO Practitioner - Nurse Practitioner 5890221915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians

Practice addresses (Care Compare)

701 S New Ballas Rd
Suite 510
Saint Louis, MO 63141-8701
Phone (314) 251-6710

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2015022116MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Nov 25, 2024 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

701 S New Ballas Rd
Ste 510
Saint Louis, MO 63141
Phone (314) 251-6710

701 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-6710

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1043038334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 SPRAGUES MILL CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113327",
            "telephone_number": "636-751-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S NEW BALLAS RD STE 510",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418726",
            "telephone_number": "314-251-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTELLO",
        "first_name": "TRISTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2015022116",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024043059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.