Melanie Marie Boon, APN – Family Nurse Practitioner

Key facts

NPI: 1477925428
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 2015023448 (MO)
Practice address: 508 Old Smizer Mill Rd
Fenton, MO 63026-3538
Phone: (636) 343-5223
NPI assigned: Oct 28, 2015
Sex: Female
Sole proprietor: No

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.

Western Anesthesiology Associates, Inc. Anesthesiology Physician · Saint Louis, MO · NPI 1275646754

Medicare reassignment Care Compare group NPD MO
Physician Specialists of St Lukes LLC Internal Medicine Physician · Chesterfield, MO · NPI 1235168410

NPD (past)

Hospital & facility affiliations 2

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

Mercy Hospitals East Communities General Acute Care Hospital · Saint Louis, MO · NPI 1427098169

Care Compare affiliation Hospital
Mercy Hospitals East Communities Land Ambulance · Saint Louis, MO · NPI 1881329902

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2015
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Western Anesthesiology Associates Inc (251 clinicians)

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-4687

Hospital & facility affiliations

Mercy Hospital St Louis Hospital · Saint Louis, MO · CCN 260020

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MO
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20160223002241	MO	Practitioner - Nurse Practitioner	3476858895	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
2015023448	MO	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Western Anesthesiology Associates, Inc.		Current since Aug 26, 2023	Accepting new patients
Physician Specialists of St Lukes LLC		Past	Accepting new patients

Locations

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	2015023448	MO	Yes

Addresses

Primary practice location

508 Old Smizer Mill Rd
Fenton, MO 63026-3538

Mailing address

508 Old Smizer Mill Rd
Fenton, MO 63026-3538
Phone (636) 343-5223

Other providers in Fenton, MO

All providers in Fenton, MO · Family Nurse Practitioner in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.