Altea Medical Missouri LLC
Organization Active NPI Geriatric Medicine (Internal Medicine) Physician · Wildwood, MO
NPI 1649032608 · NPPES record last updated Jul 31, 2026
Key facts
- NPI
- 1649032608
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- Legal business name
- ALTEA MEDICAL MISSOURI LLC
- Practice address
- 1441 Charic Dr
Wildwood, MO 63021-2001 - Phone
- (888) 408-7008
- NPI assigned
- Jan 25, 2024
- Organization subpart
- No
Authorized official
- Name
- Mary Belen Arndt
- Title
- Director of RCM
- Phone
- (855) 722-9700
Practitioners 35
-
Kelli Marie Cash, APRN, FNP-BC
-
Amber Cook, NP-C
-
Victoria Gelfand, NP
-
Lakesha Lynette Hill, DNP, APRN
-
Jared Michael Hu, FNP-BC
-
Mai Tran Hunt, M.D.
-
Ornela Claude Ika, APRN, PMHNP-BC
-
Andrea E Ivy, N.P.
-
Elizabeth H Maylack, D.O.
-
Betsy L Nelson, FNP
-
Ruth O Ogunniyi, ANP
-
Jawed H. Siddiqui, M.D.
-
Carmen Triguero, NP
-
Adewumi Bakare, DMS, PA
-
Jodhvir Sarai, MD
-
Kevin Sidhu, DO
-
Ramon Trinidad III, DNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240814002635 | MO | Part B Supplier - Clinic/Group Practice | 0143768762 |
Receives reassigned benefits from 33 practitioners Practice locations: Cedar Hill, MO; Wildwood, MO; Town and Country, MO; Saint Louis, MO; Saint Charles, MO; Rolla, MO; Perryville, MO; Normandy, MO… |
National Provider Directory
Locations
610 Prigge Rd
Saint Louis, MO 63138
Phone (314) 741-9339
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician |
207QA0505X | |||
| Internal Medicine Physician |
207R00000X | |||
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X | Yes | ||
| Physical Medicine & Rehabilitation Physician |
208100000X |
Addresses
Primary practice location
1441 Charic Dr
Wildwood, MO 63021-2001
Mailing address
400 E Rivulon Blvd Ste 103
Gilbert, AZ 85297-0096
Other providers in Wildwood, MO
- 212 Degrees of Wellness, LLC
- Stacey Lynn Abby
- Aegis Group Practice LLC
- Anne T. Riordan, M.D. P.C
- Meskerm Workiye Asfaw
- Ibrahim Atiq
- Annette Marie Bach
- Skylar Nichol Bair
All providers in Wildwood, MO · Geriatric Medicine (Internal Medicine) Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.