Individual provider Active NPI

Allissa Speiser, PA

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1922627728
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021020068 Issued in MO
Practice address
621 S New Ballas Rd Ste 297a
Saint Louis, MO 63141-8200
Phone
(314) 251-6364
NPI assigned
Apr 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 0110007906 VA
Physician Assistant 363A00000X 2021020068 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 297a
Saint Louis, MO 63141-8200

Mailing address

621 S New Ballas Rd Ste 297a
Saint Louis, MO 63141-8200
Phone (314) 251-6364

Other practice location 1

701 S. New Ballas Road
Suite 310
Saint Louis, MO 63141
Phone (314) 251-8750

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
I20220518001996 MO Practitioner - Physician Assistant 9638573702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Burn and Plastic Surgery LLCGroup PAC ID 4688622822, 14 clinicians

Practice addresses (Care Compare)

701 S New Ballas Rd
Suite 310
Saint Louis, MO 63141-8725
Phone (314) 251-8750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2021020068MOMDPhysician Assistant
0110007906VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1922627728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 297A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418200",
            "telephone_number": "314-251-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 297A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418200",
            "telephone_number": "314-251-6364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 S. New Ballas Road",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "63141",
            "country_code": "US",
            "telephone_number": "314-251-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEISER",
        "first_name": "ALLISSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-11",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007906",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021020068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.