Individual provider Active NPI

Marissa Lewis, M.D.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1164874822
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2019016334 Issued in MO
Practice address
660 S Euclid Ave
Saint Louis, MO 63110-1010
Phone
(314) 747-4156
NPI assigned
Jul 6, 2016
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2019016334 MO Primary

Addresses

Primary practice location

660 S Euclid Ave
Saint Louis, MO 63110-1010

Mailing address

2627 Heger CT
Saint Louis, MO 63110-3417

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
I20200529001912 MO Practitioner - Emergency Medicine 5496086746 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital SouthGroup PAC ID 8426962556, 45 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital South CurrentSince Mar 4, 2024 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jun 3, 2024 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jun 3, 2024 Accepting new patients
Mercy Hospital Jefferson CurrentSince Jun 3, 2024 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jun 3, 2024 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Mar 8, 2023 Accepting new patients
Mercy Hospital Jefferson CurrentSince Jun 3, 2024 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Mar 4, 2024 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Restore Health LLP CurrentSince Sep 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jun 3, 2024 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

12101 Woodcrest Executive Dr
Ste 103
Saint Louis, MO 63141
Phone (314) 983-9355

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 13

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.

View all 13

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1164874822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 HEGER CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARISSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2019016334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.