Individual provider Active NPI

Kirsten Tara Yeh, PNP

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1255843660
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2021010431 Issued in MO
Practice address
1 Childrens PL
Div Ped Endocrinology and Diabetes
Saint Louis, MO 63110-1002
Phone
(314) 454-6051
Fax
(314) 454-6225
NPI assigned
Oct 26, 2017
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2021010431 MO Primary

Addresses

Primary practice location

1 Childrens PL
Div Ped Endocrinology and Diabetes
Saint Louis, MO 63110-1002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6051

Other identifiers 1

IdentifierTypeStateIssuer
420099359MedicaidMO

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712002375 MO Practitioner - Nurse Practitioner 1254733306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021010431MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Aug 13, 2021 Accepting new patients
Washington University CurrentSince Aug 13, 2021 Accepting new patients
Washington University Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2122 Troy Rd
Edwardsville, IL 62025
Phone (618) 655-0386

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1224 Graham Rd
Ste 2010
Florissant, MO 63031
Phone (314) 839-5232

1 Childrens Pl
#9S
Saint Louis, MO 63110

12436 Tesson Ferry Rd
Saint Louis, MO 63128
Phone (314) 454-6336

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

5114 Mid America Plz
Ste 3A
Saint Louis, MO 63129
Phone (314) 454-6120

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

13001 North Outer 40 Rd
Town and Country, MO 63017
Phone (314) 454-3013

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1255843660",
    "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": "314-454-6051",
            "fax_number": "314-454-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED ENDOCRINOLOGY AND DIABETES",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6051",
            "fax_number": "314-454-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEH",
        "first_name": "KIRSTEN",
        "middle_name": "TARA",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2025-04-17",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2021010431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420099359",
            "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 Childrens Pl",
            "address_2": "Div Ped Endocrinology and Diabetes",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "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.