MS. MARY KATHERINE KINWORTHY CRNA
NPI 1003272642
Nurse Anesthetist, Certified Registered in Saint Louis, MO
About Ms. Mary Katherine Kinworthy Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. MARY KATHERINE KINWORTHY CRNA (NPI 1003272642) is an individual nurse anesthetist, certified registered in Saint Louis, Missouri, licensed in Missouri (2018003033) and active in the NPI registry since January 2016.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Mary Katherine Kinworthy Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Mary Kinworthy reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Louis, MO 63141
- Reassigned Medicare billing, Missouri enrollment
- 56 clinicians in this Medicare group
Chesterfield, MO 63017
- Reassigned Medicare billing, Missouri enrollment
- 221 clinicians in this Medicare group
Chesterfield, MO 63017
- Reassigned Medicare billing, Missouri enrollment
- 81 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT LOUIS, MO 63141
CREVE COEUR, MO 63141
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Kinworthy's NPI number?
The NPI number for Mary Kinworthy is 1003272642. It was assigned to this individual provider in the NPPES registry on January 12, 2016.
Where is Mary Kinworthy located?
Mary Kinworthy practices at 12634 Olive Blvd Dept Anesthesiology, Saint Louis, MO 63141. The listed phone number is (800) 862-9980.
What is Mary Kinworthy's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Mary Kinworthy enrolled in Medicare?
Yes. Mary Kinworthy is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mary Kinworthy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Kinworthy reassigns Medicare benefits to 3 organizations: Premier Anesthesia LLC (Saint Louis, MO), Metro-West Anesthesia Group Inc (Chesterfield, MO) and Mid-West Anesthesia Partners, LLC (Chesterfield, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Kinworthy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Kinworthy was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ms. Mary Katherine Kinworthy, CRNA · NPI 1003272642
Nurse Anesthetist, Certified Registered physician in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since January 12, 2016.
## Identity
- **NPI:** 1003272642 (Entity type: Individual)
- **Enumerated:** January 12, 2016
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 2018003033 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 12634 OLIVE BLVD, DEPT ANESTHESIOLOGY, Saint Louis, MO 63141-6337
- **Phone:** (800) 862-9980 · **Fax:** (314) 362-1185
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Premier Anesthesia LLC (NPI 1225073828, Saint Louis, MO); Metro-West Anesthesia Group Inc (NPI 1245427335, Chesterfield, MO); Mid-West Anesthesia Partners, LLC (NPI 1851254304, Chesterfield, MO) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 25, 2024
- **Other identifiers:** Medicaid 910051453 (MO)
---
Source: [NPI Profile](https://npiprofile.com/npi/1003272642) · Data from the CMS NPPES public registry.