Individual provider Active NPI

Elma Sahbaz, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1184499774
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023046597 Issued in MO
Practice address
3557 Forest Dale Dr
Saint Louis, MO 63125-4212
Phone
(314) 479-6411
NPI assigned
Nov 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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 2019026708 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023046597 MO Primary

Addresses

Primary practice location

3557 Forest Dale Dr
Saint Louis, MO 63125-4212

Mailing address

3557 Forest Dale Dr
Saint Louis, MO 63125-4212
Phone (314) 479-6411

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
I20240209000202 MO Practitioner - Nurse Practitioner 4587007232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Research Associates PCGroup PAC ID 5597662080, 21 clinicians

Practice addresses (Care Compare)

777 Craig Rd
Suite 200
Creve Coeur, MO 63141-7190
Phone (314) 549-8494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019026708MOMDRegistered Nurse

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1700784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1184499774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3557 FOREST DALE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254212",
            "telephone_number": "314-479-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3557 FOREST DALE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254212",
            "telephone_number": "314-479-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHBAZ",
        "first_name": "ELMA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-24",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2019026708",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023046597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.