Mary Kopsky, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2019024727 Issued in MO

Practice address

615 S New Ballas Rd
Suite Yg 230
St. Louis, MO 63141

Phone

(314) 251-5550

NPI assigned

Nov 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkopsky587827@directc.mercy.net

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.

• Mercy Clinic Kids Gi, LLC

  • Pediatric Gastroenterology Physician
  • Saint Louis, MO
  • NPI 1033352885
  Medicare reassignment NPD

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1336740828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7263 BALSON AVE",
            "address_2": "1W",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63130",
            "telephone_number": "314-456-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "SUITE YG 230",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPSKY",
        "first_name": "MARY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2019024727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Kopp, LPC
• Daniel A Kopp, M.D.
• Diane S. Kopp, M.S.W
• Barbara A. Koppe, MSW, LCSW
• Pamela Koprowski
• Ray John Kopsky, PH.D., MSW
• Korede Foundation
• Korede Inc.
• Melissa Korenblat-Hanin, MSW, LCSW
• Kevin M Korenblat, MD

• Pediatric Nurse Practitioner in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.