Individual provider Active NPI

Sarah Elisabeth Radecki, PA

  • Physician Assistant
  • Eureka, MO
National Provider Identifier
1609505874
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2022042681 Issued in MO
Practice address
20 The Legends Pkwy Ste 100
Eureka, MO 63025-3825
Phone
(636) 549-0121
NPI assigned
Jun 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2022042681 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

20 The Legends Pkwy Ste 100
Eureka, MO 63025-3825

Mailing address

16523 Wild Horse Creek Rd Apt 1216
Chesterfield, MO 63017-1419

Other practice location 1

16523 Wild Horse Creek Rd Apt 1216
Chesterfield, MO 63017-1419
Phone (314) 973-9717

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
I20221223000431 MO Practitioner - Physician Assistant 7911377551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

20 The Legends Pkwy
Eureka, MO 63025-3823
Phone (636) 938-3399

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052
  • 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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Oct 25, 2022 Accepting new patients
Mercy Clinic East Communities CurrentSince Oct 25, 2022 Accepting new patients

Locations

20 The Legends Pkwy
Ste 100
Eureka, MO 63025
Phone (636) 549-0121

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

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

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": "1654387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1609505874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16523 WILD HORSE CREEK RD APT 1216",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 THE LEGENDS PKWY STE 100",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630253825",
            "telephone_number": "636-549-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16523 Wild Horse Creek Rd Apt 1216",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630171419",
            "country_code": "US",
            "telephone_number": "314-973-9717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADECKI",
        "first_name": "SARAH",
        "middle_name": "ELISABETH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-05",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022042681",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, MO

Sources for this page

Verify at the official NPI Registry.