Individual provider Active NPI

Robert Howard Tversky, ANP-C

  • Adult Health Nurse Practitioner
  • Olivette, MO
National Provider Identifier
1386722841
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2008008844 Issued in MO
Practice address
9457 Engel LN
Olivette, MO 63132-3417
Phone
(314) 323-9198
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2008008844 MO
Adult Health Nurse Practitioner 363LA2200X 2008008844 MO Primary

Addresses

Primary practice location

9457 Engel LN
Olivette, MO 63132-3417

Mailing address

9457 Engel LN
Olivette, MO 63132-3417
Phone (314) 323-9198

Other practice location 1

7777 Bonhomme Ave Ste 1800
Clayton, MO 63105-1931
Phone (855) 229-2177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250722001505 IL Practitioner - Nurse Practitioner 7012096027 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008008844MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Practice PLLC CurrentSince Mar 31, 2025 Accepting new patients
Domicilliary Service LLC Past Accepting new patients

Locations

332 S Michigan Ave
Ste 900
Chicago, IL 60604
Phone (813) 395-1073

13900 Riverport Dr
Maryland Heights, MO 63043
Phone (314) 209-2700

13900 Riverport Dr
Ste 101
Maryland Heights, MO 63043

7777 Bonhomme Ave
Ste 1800
Saint Louis, MO 63105
Phone (314) 209-2800

2975 Regent Blvd
#201
Irving, TX 75063

Organizations & group practices 2

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1386722841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9457 ENGEL LN",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631323417",
            "telephone_number": "314-323-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9457 ENGEL LN",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631323417",
            "telephone_number": "314-323-9198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Bonhomme Ave Ste 1800",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "MO",
            "postal_code": "631051931",
            "country_code": "US",
            "telephone_number": "855-229-2177",
            "fax_number": "314-464-0759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TVERSKY",
        "first_name": "ROBERT",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2008008844",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2008008844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olivette, MO

Sources for this page

Verify at the official NPI Registry.