Individual provider Active NPI

Kaylene Amanda Inama, AGNP

  • Gerontology Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1528440450
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2017003908 Issued in MO
Practice address
10 Barnes West Dr
Div Im Geriatrics, Ste 200
Saint Louis, MO 63141-6287
Phone
(314) 273-4374
Fax
(314) 983-0155
NPI assigned
Jun 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2017003908 MO Primary

Addresses

Primary practice location

10 Barnes West Dr
Div Im Geriatrics, Ste 200
Saint Louis, MO 63141-6287

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 273-4374

Other identifiers 1

IdentifierTypeStateIssuer
420041791MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20170503000106 MO Practitioner - Nurse Practitioner 7214241215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nebraska College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

10 Barnes W Dr
Saint Louis, MO 63141-6350

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • BJC Home Care Services Home health agency, Saint Louis, MO, CCN 267276
  • Elite Home Health Home health agency, Creve Coeur, MO, CCN 267603
  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017003908MOMDGerontology Nurse Practitioner

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 4

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": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1528440450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-273-4374",
            "fax_number": "314-983-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BARNES WEST DR",
            "address_2": "DIV IM GERIATRICS, STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416287",
            "telephone_number": "314-273-4374",
            "fax_number": "314-983-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INAMA",
        "first_name": "KAYLENE",
        "middle_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-27",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2017003908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420041791",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "10 Barnes West Dr",
            "address_2": "Div IM Geriatrics, Ste 200",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.