Individual provider Active NPI

Alexandra Gianoli, PA-C, MMS,ATC-L, MAT

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1952754764
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021024746 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6339
NPI assigned
Jul 16, 2016
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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 3540 SC
Physician Assistant 363A00000X 2021024746 MO Primary
Athletic Trainer 2255A2300X AL2885 FL

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

621 S New Ballas Rd Ste 112a
Saint Louis, MO 63141-8252
Phone (314) 251-6339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210401000719 SC Practitioner - Physician Assistant 0648687061 Reassigns benefits to 2 organizations
I20210922000639 MO Practitioner - Physician Assistant 0648687061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians
Mercy Clinic Adult Hospitalists - St. Louis, LLCGroup PAC ID 6002809944, 139 clinicians

Practice addresses (Care Compare)

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AL2885FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Sep 20, 2021 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 20, 2021 Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

621 S New Ballas Rd
Ste 112A
Saint Louis, MO 63141
Phone (314) 251-6339

Interoperability endpoints

  • Direct secure messaging: agianoli43699@direct.anmedhealth.net

Organizations & group practices 6

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 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": "1468627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1952754764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 112A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418252",
            "telephone_number": "314-251-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANOLI",
        "first_name": "ALEXANDRA",
        "credential": "PA-C, MMS,ATC-L, MAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-16",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021024746",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL2885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.