Individual provider Active NPI

Jessica Pearl Mei-Jan Lucido, NP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1508309717
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2016012526 Issued in MO
Practice address
625 S. New Ballas Road
Suite 2015
Saint Louis, MO 63141
Phone
(314) 251-1100
Fax
(314) 251-1140
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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 2012020364 MO
Nurse Practitioner 363L00000X 2016012526 MO Primary

Addresses

Primary practice location

625 S. New Ballas Road
Suite 2015
Saint Louis, MO 63141

Mailing address

625 S. New Ballas Road
Suite 2015
Saint Louis, MO 63141
Phone (314) 251-1100

Other names 1

  • Ms. Jessica Pearl Me-Jan Lau Former name

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
I20170105001795 MO Practitioner - Nurse Practitioner 8729369707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

625 S New Ballas Rd
Suite 2015
Saint Louis, MO 63141-8253
Phone (314) 251-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012020364MOMDRegistered Nurse
2016012526MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Past Accepting new patients
Saint Luke'S Physician Group Inc Nurse Practitioner Past Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1508309717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S. NEW BALLAS ROAD",
            "address_2": "SUITE 2015",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-1100",
            "fax_number": "314-251-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S. NEW BALLAS ROAD",
            "address_2": "SUITE 2015",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-251-1100",
            "fax_number": "314-251-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIDO",
        "first_name": "JESSICA",
        "middle_name": "PEARL MEI-JAN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2012020364",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016012526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LAU",
            "middle_name": "PEARL ME-JAN",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.