Active NPI
Marcella M Petzchen, NP
- Adult Health Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 051062
- Practice address
- 3660 Vista Ave
Suite 207
Saint Louis, MO 63110-2540 - Phone
- (314) 977-6100
- Fax
- (314) 977-6137
- NPI assigned
- Apr 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 051062 | MO | |
| Primary Care Nurse Practitioner | 363LP2300X | 051062 | MO | |
| Women's Health Nurse Practitioner | 363LW0102X | 051062 | MO | |
| Adult Health Nurse Practitioner | 363LA2200X | 051062 | MO | Primary |
Addresses
Primary practice location
3660 Vista Ave
Suite 207
Saint Louis, MO 63110-2540
Mailing address
3691 Rutger Ave
Provider Enrollment
St Louis, MO 63110
Phone (314) 977-4440
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1968
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000
1225 S Grand Blvd
Saint Louis, MO 63104-1016
3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (314) 257-7400
3655 Vista Ave
Saint Louis, MO 63110-2539
Phone (314) 977-4663
3685 Vista Ave
Saint Louis, MO 63110-2539
Phone (314) 257-7000
Hospital & facility affiliations
- SSM Health Saint Louis University Hospital
- SSM Health St Mary's Hospital - St Louis
- SSM Health Rehabilitation Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 68.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.22
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051062 | MO | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SLH Physicians LLC | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| St Alexius Emergency Physicians LLC | Past | Accepting new patients | |
| SSM Medical Group Inc. | Past | Accepting new patients |
Locations
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
1035 Bellevue Ave
Ste 305
Saint Louis, MO 63117
Phone (314) 644-6161
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101
Interoperability endpoints
- mpetzchen236927@direct-ehr-ssmhc.com
Organizations & group practices 5
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.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
-
- Emergency Medicine Physician
- Saint Louis, MO
- NPI 1881668051
-
dba SLUCare Physician Group
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
-
- Emergency Medicine Physician
- Saint Louis, MO
- NPI 1578796157
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health Cardinal Glennon Children's Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
dba SSM Health St. Mary's Hospital - St. Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
Inpatient rehabilitation facility
-
dba SSM Health Saint Louis University Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1255393716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3691 RUTGER AVE",
"address_2": "PROVIDER ENROLLMENT",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63110",
"telephone_number": "314-977-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3660 VISTA AVE",
"address_2": "SUITE 207",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102540",
"telephone_number": "314-977-6100",
"fax_number": "314-977-6137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETZCHEN",
"first_name": "MARCELLA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-03",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "051062",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MO",
"license": "051062",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MO",
"license": "051062",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "051062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.