Individual provider Active NPI

Matthew Stephen Zide, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1922752591
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2022004012 Issued in MO
Practice address
600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035
Phone
(314) 286-1700
Fax
(314) 970-9094
NPI assigned
Feb 11, 2022
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2022004012 MO Primary

Addresses

Primary practice location

600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 286-1700

Other identifiers 1

IdentifierTypeStateIssuer
420108206MedicaidMO

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
I20220413001537 MO Practitioner - Nurse Practitioner 6901292259 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

600 S Taylor Ave
Suite 122
Saint Louis, MO 63110-1035
Phone (314) 286-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022004012MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Apr 4, 2022 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Apr 4, 2022 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Apr 4, 2022 Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

851 E 5th St
Ste 154
Washington, MO 63090
Phone (314) 251-6663

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

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.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1922752591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-286-1700",
            "fax_number": "314-970-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S TAYLOR AVE",
            "address_2": "DEPT PSYCHIATRY, STE 122",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101035",
            "telephone_number": "314-286-1700",
            "fax_number": "314-970-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIDE",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-11",
        "last_updated": "2025-04-17",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2022004012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420108206",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "600 S Taylor Ave",
            "address_2": "Dept Psychiatry, Ste 122",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101035",
            "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.