Individual provider Active NPI

Paige Cosmas, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1689388175
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022037798 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-0175
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209026479 IL
Family Nurse Practitioner 363LF0000X 2022037798 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

4326 Haven St
Saint Louis, MO 63116-2148

Other names 1

  • Paige Henderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230125003499 IL Practitioner - Nurse Practitioner 6709257967 Reassigns benefits to 1 organization
I20231103000684 MO Practitioner - Nurse Practitioner 6709257967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

159 E McArthur Dr
Bethalto, IL 62010-1918
Phone (618) 258-7504

676 Gravois Bluffs Blvd
Suite A1
Fenton, MO 63026-7742
Phone (636) 492-2245

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209026479ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Oct 30, 2023 Accepting new patients
Mercy Hospitals East Communities CurrentSince Oct 30, 2023 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Dec 11, 2023 Accepting new patients
Anderson Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

159 E McArthur Dr
Bethalto, IL 62010
Phone (618) 258-7380

3417 Anderson Healthcare Dr
Ste 200
Edwardsville, IL 62025
Phone (618) 288-8500

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

676 Gravois Bluffs Blvd
Ste A1
Fenton, MO 63026
Phone (636) 492-2245

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

555 Washington Sq
Washington, MO 63090
Phone (636) 390-1777

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 4

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 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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1689388175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4326 HAVEN ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSMAS",
        "first_name": "PAIGE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026479",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022037798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "HENDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.