Individual provider Active NPI

Tara Marie Casaletto, MSN-FNP

  • Nurse Practitioner
  • Wentzville, MO
National Provider Identifier
1336003128
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2026007963 Issued in MO
Practice address
1520 Wentzville Pkwy
Wentzville, MO 63385-3408
Phone
(636) 497-4060
NPI assigned
Dec 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020006031 MO
Nurse Practitioner 363L00000X 2026007963 MO Primary

Addresses

Primary practice location

1520 Wentzville Pkwy
Wentzville, MO 63385-3408

Mailing address

PO Box 959354
Saint Louis, MO 63195-9354
Phone (636) 497-4060

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

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
I20260326000543 MO Practitioner - Nurse Practitioner 5294210423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1520 Wentzville Pkwy
Wentzville, MO 63385-3408
Phone (636) 497-4000

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2026007963MOMDNurse Practitioner
2020006031MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1336003128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959354",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631959354",
            "telephone_number": "636-497-4060",
            "fax_number": "636-497-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 WENTZVILLE PKWY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853408",
            "telephone_number": "636-497-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASALETTO",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSN-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020006031",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2026007963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 Wentzville Pkwy",
            "city": "Wentzville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633853408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

Verify at the official NPI Registry.