Individual provider Active NPI

Alyssa Khristine Durzo, PNP

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1871464388
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2025039807 Issued in MO
Practice address
8888 Ladue Rd
Ste 100
Saint Louis, MO 63124-2326
Phone
(314) 862-4050
Fax
(314) 862-1141
NPI assigned
Sep 16, 2025
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2025039807 MO Primary

Addresses

Primary practice location

8888 Ladue Rd
Ste 100
Saint Louis, MO 63124-2326

Mailing address

PO Box 7412125
Chicago, IL 60674-2125
Phone (314) 862-4050

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20251023002334 MO Practitioner - Nurse Practitioner 3072001700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1234 S Kingshighway Blvd
Suite 1800
Saint Louis, MO 63110-2179

PO Box
Chicago, IL 60674

PO Box
Suite 7412125
Chicago, IL 60674-2125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025039807MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Oct 13, 2025 Accepting new patients
Washington University CurrentSince Oct 13, 2025 Accepting new patients
Washington University Past Accepting new patients

Locations

8888 Ladue Rd
Ste 100
Saint Louis, MO 63124
Phone (314) 862-4050

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

NPI Registry JSON

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1871464388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412125",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742125",
            "telephone_number": "314-862-4050",
            "fax_number": "314-862-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8888 LADUE RD",
            "address_2": "STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242326",
            "telephone_number": "314-862-4050",
            "fax_number": "314-862-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURZO",
        "first_name": "ALYSSA",
        "middle_name": "KHRISTINE",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2025039807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "8888 LaDue Rd",
            "address_2": "Ste 100",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631242326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.