MISRAK GEBISSA
NPI 1184175085
Clinical Nurse Specialist - Gerontology in Creve Coeur, MO
About Misrak Gebissa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MISRAK GEBISSA (NPI 1184175085) is an individual gerontology provider in Creve Coeur, Missouri, licensed in Missouri (AG0416096) and active in the NPI registry since October 2016.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Misrak Gebissa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Misrak Gebissa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Creve Coeur, MO 63141
- Reassigned Medicare billing, Missouri enrollment
- 4 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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Misrak Gebissa's NPI number?
The NPI number for Misrak Gebissa is 1184175085. It was assigned to this individual provider in the NPPES registry on October 17, 2016.
Where is Misrak Gebissa located?
Misrak Gebissa practices at 9 Sackston Woods Ln, Creve Coeur, MO 63141. The listed phone number is (877) 748-7030.
What is Misrak Gebissa's specialty?
The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Gerontology, with taxonomy code 364SG0600X.
Is Misrak Gebissa enrolled in Medicare?
Yes. Misrak Gebissa is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Misrak Gebissa's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Misrak Gebissa reassigns Medicare benefits to Mid-Town Medical Practice, LLC (Creve Coeur, MO). The 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 Misrak Gebissa'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 Misrak Gebissa was last updated on October 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Misrak Gebissa · NPI 1184175085
Gerontology physician in Creve Coeur, Missouri. Individual provider, active in the CMS NPPES registry since October 17, 2016.
## Identity
- **NPI:** 1184175085 (Entity type: Individual)
- **Enumerated:** October 17, 2016
- **Primary specialty:** Clinical Nurse Specialist - Gerontology · taxonomy 364SG0600X
- **State license:** AG0416096 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 9 SACKSTON WOODS LN, Creve Coeur, MO 63141-8228
- **Phone:** (877) 748-7030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Mid-Town Medical Practice, LLC (NPI 1023467008, Creve Coeur, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 17, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1184175085) · Data from the CMS NPPES public registry.