Individual provider Active NPI

Sara Mendelow Wootten, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1619359486
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015021537 Issued in MO
Practice address
701 S New Ballas Rd Ste 300
Saint Louis, MO 63141-8725
Phone
(314) 251-5890
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015021537 MO Primary

Addresses

Primary practice location

701 S New Ballas Rd Ste 300
Saint Louis, MO 63141-8725

Mailing address

701 S New Ballas Rd Ste 300
Saint Louis, MO 63141-8725
Phone (314) 251-5890

Other identifiers 2

IdentifierTypeStateIssuer
1619359486MedicaidMO
P01628637OtherMORAILROAD MEDICARE

Other names 1

  • Sara Mendelow 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
I20150807014288 MO Practitioner - Nurse Practitioner 1254645963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

12680 Olive Blvd
Suite 300
Saint Louis, MO 63141-6322
Phone (314) 251-6050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Sep 3, 2024 Accepting new patients
Mercy Clinic East Communities Family CurrentSince Aug 3, 2015 Accepting new patients
Mercy Clinic East Communities CurrentSince Aug 3, 2015 Accepting new patients

Locations

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

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

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

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

701 S New Ballas Rd
Ste 300
Saint Louis, MO 63141
Phone (314) 251-5890

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1619359486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S NEW BALLAS RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418725",
            "telephone_number": "314-251-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S NEW BALLAS RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418725",
            "telephone_number": "314-251-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTTEN",
        "first_name": "SARA",
        "middle_name": "MENDELOW",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015021537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619359486",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01628637",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "MENDELOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.