Individual provider Active NPI

Amanda Nicole Waltos Hieger, MD

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
National Provider Identifier
1508350091
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2018020849 Issued in MO
Practice address
10777 Sunset Office Dr Ste 200
Saint Louis, MO 63127-1019
Phone
(314) 842-4802
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2018020849 MO Primary

Addresses

Primary practice location

10777 Sunset Office Dr Ste 200
Saint Louis, MO 63127-1019

Mailing address

9874 Vicksburg Siege CT
Saint Louis, MO 63123-1809
Phone (440) 666-0410

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
I20220909002046 MO Practitioner - Obstetrics/Gynecology 3678822244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

10777 Sunset Office Dr
Suite 200
Saint Louis, MO 63127-1019
Phone (314) 842-4802

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Sep 6, 2022 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

10777 Sunset Office Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 842-4802

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

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

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.

Hospital & facility affiliations 3

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1508350091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9874 VICKSBURG SIEGE CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631231809",
            "telephone_number": "440-666-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 SUNSET OFFICE DR STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271019",
            "telephone_number": "314-842-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTOS HIEGER",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2018020849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.