Individual provider Active NPI

Kristen Emily Polito, PA-C

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1073186300
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021010556 Issued in MO
Practice address
9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone
(314) 373-5740
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2021010556 MO Primary

Addresses

Primary practice location

9556 Manchester Rd
Saint Louis, MO 63119-1313

Mailing address

9556 Manchester Rd
Saint Louis, MO 63119-1313

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
I20210727001622 MO Practitioner - Physician Assistant 2567865611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

1005 S Big Bend Blvd
Saint Louis, MO 63117-1605
Phone (314) 961-2255

1090 N Hwy 67 St
Florissant, MO 63031-4720
Phone (314) 961-2255

10923 Olive Blvd
Creve Coeur, MO 63141-7740
Phone (314) 961-2255

12409 Saint Charles Rock Rd
Bridgeton, MO 63044-2507
Phone (314) 961-2255

13861 Manchester Rd
Ballwin, MO 63011-4503
Phone (314) 961-2255

2060 Hampton Ave
Saint Louis, MO 63139-2903
Phone (314) 961-2255

2980 Dougherty Ferry Rd
Saint Louis, MO 63122-3366
Phone (314) 961-2255

3114 S Grand Blvd
Saint Louis, MO 63118-1012
Phone (314) 961-2255

7816 Big Bend Blvd
Webster Groves, MO 63119-2702
Phone (314) 961-2255

8213 Delmar Blvd
Saint Louis, MO 63124-2104
Phone (314) 961-2255

8961 Page Ave
Overland, MO 63114-6104
Phone (314) 961-2255

9538 Gravois Rd
Affton, MO 63123-4558
Phone (314) 961-2255

9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 961-2255

Merit-based Incentive Payment System (MIPS)

Final score
42.87 of 100Reported as group
Quality
31.86
Promoting interoperability
0
Improvement activities
40
Cost
61.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2021010556MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Total Access Urgent Care, PC CurrentSince Jul 26, 2021 Accepting new patients
Total Access Urgent Care, PC CurrentSince Jul 26, 2021 Accepting new patients

Locations

12409 Saint Charles Rock Rd
Bridgeton, MO 63044
Phone (314) 455-4046

10923 Olive Blvd
Creve Coeur, MO 63141
Phone (314) 764-2953

1090 N Highway 67 St
Florissant, MO 63031

507 S Main St
O Fallon, MO 63366
Phone (636) 409-1092

4201 Highway K
O Fallon, MO 63368

6900 Chippewa St
Saint Louis, MO 63109

3114 S Grand Blvd
Saint Louis, MO 63118

9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740

2980 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (636) 529-8411

12616 Lamplighter Square Shpg Ctr
Saint Louis, MO 63128

2060 Hampton Ave
Saint Louis, MO 63139
Phone (314) 696-2341

1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950

1890 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 887-2667

13861 Manchester Rd
Wildwood, MO 63011
Phone (636) 220-9333

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.

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1073186300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9556 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9556 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191313",
            "telephone_number": "314-373-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "KRISTEN",
        "middle_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021010556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.