Individual provider Active NPI

Mikayla Anne Galucia, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1487595088
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2026016141 Issued in MO
Practice address
12680 Olive Blvd Ste 300
Saint Louis, MO 63141-6322
Phone
(314) 251-8888
Fax
(314) 251-8889
NPI assigned
Apr 6, 2026
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 2026016141 MO Primary

Addresses

Primary practice location

12680 Olive Blvd Ste 300
Saint Louis, MO 63141-6322

Mailing address

12680 Olive Blvd Ste 300
Saint Louis, MO 63141-6322
Phone (314) 251-8888

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260612001416 MO Order and Referring Only - Family PracticePractitioner - Family Practice 8224500046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2026016141MOMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1487595088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-251-8888",
            "fax_number": "314-251-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-251-8888",
            "fax_number": "314-251-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALUCIA",
        "first_name": "MIKAYLA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2026016141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.