Individual provider Active NPI

Ashley Tusevljak

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1467997536
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016043092 Issued in MO
Practice address
845 N New Ballas CT
Unit 360
Saint Louis, MO 63141-7134
Phone
(314) 219-1247
NPI assigned
Dec 28, 2016
Last updated
Dec 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016043092 MO Primary

Addresses

Primary practice location

845 N New Ballas CT
Unit 360
Saint Louis, MO 63141-7134

Mailing address

845 N New Ballas CT
Unit 360
Saint Louis, MO 63141-7134
Phone (314) 219-1247

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
I20171110000101 MO Practitioner - Nurse Practitioner 6305102153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

555 Washington SQ
Washington, MO 63090-5343
Phone (636) 390-1777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016043092MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Nov 17, 2019 Accepting new patients

Locations

660A S Truman Blvd
Festus, MO 63028
Phone (636) 206-8049

1125 Main St
Imperial, MO 63052
Phone (636) 206-8051

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

555 Washington Sq
Washington, MO 63090
Phone (636) 390-1777

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1467997536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N NEW BALLAS CT",
            "address_2": "UNIT 360",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417134",
            "telephone_number": "314-219-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N NEW BALLAS CT",
            "address_2": "UNIT 360",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417134",
            "telephone_number": "314-219-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUSEVLJAK",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016043092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.