Individual provider Active NPI

Alyssa Speranza, AGPCNP-BC

  • Nurse Practitioner
  • Chesterfield, MO
National Provider Identifier
1619759230
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2023032280 Issued in MO
Practice address
222 S Woods Mill Rd Ste 550N
Chesterfield, MO 63017-3641
Phone
(314) 434-3049
NPI assigned
Oct 18, 2023
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2023032280 MO Primary

Addresses

Primary practice location

222 S Woods Mill Rd Ste 550N
Chesterfield, MO 63017-3641

Mailing address

2200 Lasalle St Apt 515
Saint Louis, MO 63104-2771
Phone (585) 317-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

121 Saint Lukes Ctr Dr
Chesterfield, MO 63017

121 Saint Lukes Ctr Dr
Chesterfield, MO 63017-3518

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023032280MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic Surgery, LLC CurrentSince Nov 13, 2023 Accepting new patients
Open Heart Anesthesiology, LLC Past Accepting new patients

Locations

222 S Woods Mill Rd
Ste 550
Chesterfield, MO 63017
Phone (314) 434-3049

222 S Woods Mill Rd
Ste 550N
Chesterfield, MO 63017
Phone (314) 434-3049

226 S Woods Mill Rd
Ste 550
Chesterfield, MO 63017

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1619759230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 LASALLE ST APT 515",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042771",
            "telephone_number": "585-317-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 550N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173641",
            "telephone_number": "314-434-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERANZA",
        "first_name": "ALYSSA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023032280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.