Individual provider Active NPI

Mitchell Andrew Pet, MD

  • Plastic and Reconstructive Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1134428758
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
2018012226 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Div Surg Plastics
Saint Louis, MO 63110-1003
Phone
(314) 362-7388
Fax
(833) 301-0853
NPI assigned
Mar 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2018012226 MO
Plastic and Reconstructive Surgery Physician 2086S0122X 2018012226 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Div Surg Plastics
Saint Louis, MO 63110-1003

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-7388

Other identifiers 1

IdentifierTypeStateIssuer
200053721MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724002675 MO Practitioner - Plastic and Reconstructive Surgery 6507175064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Washington University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

12634 Olive Blvd
Saint Louis, MO 63141-6337
Phone (314) 996-8410

4921 Parkview PL
Suite G6TH
Saint Louis, MO 63110-1032
Phone (314) 362-7388

Hospital & facility affiliations

  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018012226MOMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Sep 1, 2018 Accepting new patients
Washington University CurrentSince Sep 1, 2018 Accepting new patients
Washington University Past Accepting new patients

Locations

2 Progress Point Pkwy
O Fallon, MO 63368
Phone (636) 344-1000

660 S Euclid Ave
Saint Louis, MO 63110

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

4921 Parkview Pl
Ste 6G
Saint Louis, MO 63110
Phone (314) 362-7388

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

1 Childrens Pl
Ste 2A
Saint Louis, MO 63110
Phone (314) 454-6022

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

660 S Euclid Ave
#8238
Saint Louis, MO 63110
Phone (314) 362-7388

Interoperability endpoints

  • Direct secure messaging: mpet649980@direct.carenet.org

Organizations & group practices 3

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1134428758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-7388",
            "fax_number": "833-301-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DIV SURG PLASTICS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-7388",
            "fax_number": "833-301-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PET",
        "first_name": "MITCHELL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2018012226",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MO",
            "license": "2018012226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200053721",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Div Surg Plastics",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.