Teresa Lynn Micotto, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2500098462 Issued in MO

Practice address

3635 Vista Ave
Saint Louis, MO 63110-2539

Phone

(314) 762-0089

NPI assigned

Jun 11, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1932580388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-762-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICOTTO",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2500098462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle R Mick, ANP-C
• Kelly Mickey, PHARMD
• Walter Lee Mickey, D.O.
• Susan Mickley, CPM
• Jan Micotto, CRNA
• Microsurgery and Brain Research Institute, P.C.
• Microvas Wellness Center
• Mid America Home Care, LLC
• Mid America Home Health Inc
• Mid County OB GYN Group, Inc

• Emergency Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.