Individual provider Active NPI

Eyerusalem Beyene, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1487584231
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2026017526 Issued in MO
Practice address
60 Brighton Park Dr
Saint Charles, MO 63303-3052
Phone
(918) 815-5540
NPI assigned
May 22, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

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 2026017526 MO Primary

Addresses

Primary practice location

60 Brighton Park Dr
Saint Charles, MO 63303-3052

Mailing address

60 Brighton Park Dr
Saint Charles, MO 63303-3052
Phone (918) 815-5540

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
I20260609002216 MO Practitioner - Nurse Practitioner 0345711461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

224 S Woods Mill Rd
Suite 550S
Chesterfield, MO 63017-3612

60 Brighton Park Dr
Saint Charles, MO 63303-3052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2026017526MOMDPsychiatric/Mental Health Nurse Practitioner

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": "1779408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1487584231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BRIGHTON PARK DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033052",
            "telephone_number": "918-815-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BRIGHTON PARK DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033052",
            "telephone_number": "918-815-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYENE",
        "first_name": "EYERUSALEM",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2026017526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.