Individual provider Active NPI

Miriam Ita Perel, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1376341016
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025006312 Issued in MO
Practice address
600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035
Phone
(314) 286-1700
Fax
(314) 970-9094
NPI assigned
Mar 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025006312 MO Primary

Addresses

Primary practice location

600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 286-1700

Other identifiers 1

IdentifierTypeStateIssuer
420154986MedicaidMO

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
I20250401000694 MO Practitioner - Nurse Practitioner 7719400738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

600 S Taylor Ave
Suite 122
Saint Louis, MO 63110-1035
Phone (314) 286-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1376341016",
    "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": "314-286-1700",
            "fax_number": "314-970-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S TAYLOR AVE",
            "address_2": "DEPT PSYCHIATRY, STE 122",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101035",
            "telephone_number": "314-286-1700",
            "fax_number": "314-970-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREL",
        "first_name": "MIRIAM",
        "middle_name": "ITA",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025006312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420154986",
            "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": "600 S Taylor Ave",
            "address_2": "Dept Psychiatry, Ste 122",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101035",
            "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.