Kimberly Sieli, M.D.

Individual provider Active NPI Pediatrics Physician · Cottleville, MO

NPI 1104987544 · NPPES record last updated Jul 11, 2017

Key facts

NPI
1104987544
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
101133 (MO)
Practice address
4525 Mid Rivers Mall Dr Ste 20
Cottleville, MO 63376-2820
Phone
(636) 441-5437
Fax
(636) 441-4398
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170606003017 MO Order and Referring Only - Pediatric Medicine
Practitioner - Pediatric Medicine
8123395597

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Pediatrics Past Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ksieli7135@directc.mercy.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 101133 MO Yes

Addresses

Primary practice location

4525 Mid Rivers Mall Dr Ste 20
Cottleville, MO 63376-2820

Mailing address

4525 Mid Rivers Mall Drive
Suite20
Cottleville, MO 63376
Phone (636) 441-5437

Other names

  • Kimberly McCowen Former name

Other providers in Cottleville, MO

All providers in Cottleville, MO · Pediatrics Physician in Missouri

Sources for this page

Verify at the official NPI Registry.