Individual provider Active NPI

Marietta R Caiarelli, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1891993481
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
142745 Issued in MO
Practice address
3646 Fairview Ave
Saint Louis, MO 63116-4747
Phone
(314) 664-5565
NPI assigned
Jul 5, 2007
Last updated
May 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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 142745 MO Primary

Addresses

Primary practice location

3646 Fairview Ave
Saint Louis, MO 63116-4747

Mailing address

14 Ponca TRL
Kirkwood, MO 63122-5112
Phone (314) 965-4470

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
I20090403000198 MO Practitioner - Nurse Practitioner 8426105602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of St Lukes LLCGroup PAC ID 3779714142, 63 clinicians
Premier Medical Physicians LLCGroup PAC ID 6507129699, 9 clinicians

Practice addresses (Care Compare)

11550 Olive Blvd
Saint Louis, MO 63141-7111
Phone (314) 542-7690

12304 Manchester Rd
Des Peres, MO 63131-4315
Phone (314) 965-6871

232 S Woods Mell Rd
Chesterfield, MO 63017-3417

2325 Dougherty Ferry Rd
Suite 104
Saint Louis, MO 63122-3356
Phone (314) 821-6889

233 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 256-8644

5551 Winghaven Blvd
100 Winghaven UC Center
O Fallon, MO 63368-3618
Phone (636) 695-2500

832 Arnold Commons Dr
Arnold, MO 63010-2164
Phone (636) 685-7899

8857 Ladue Rd a
Saint Louis, MO 63124-2045
Phone (314) 576-8189

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142745MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Physicians LLC CurrentSince Jun 1, 2025 Accepting new patients
Physician Specialists of St Lukes LLC Past Accepting new patients
St Alexius Emergency Physicians LLC Past Accepting new patients

Locations

12304 Manchester Rd
Des Peres, MO 63131
Phone (314) 965-6871

2325 Dougherty Ferry Rd
Ste 104
Saint Louis, MO 63122
Phone (314) 821-6889

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

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, 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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1891993481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PONCA TRL",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225112",
            "telephone_number": "314-965-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 FAIRVIEW AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164747",
            "telephone_number": "314-664-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIARELLI",
        "first_name": "MARIETTA",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "142745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.