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MRS. KELLY DOUGHERTY WASSEL PNP
NPI 1225303522
Nurse Practitioner - Pediatrics in Saint Louis, MO

Active since March 20, 2012PECOS Enrolled
12360 MANCHESTER RD, STE 100, SAINT LOUIS, MO 63131(314) 966-8500(314) 996-4499 Get Directions Write a Review

NPPES record last updated: June 13, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2019, Nov 15, 2016, Oct 1, 2015 (3 updates tracked since 2015).

About Mrs. Kelly Dougherty Wassel Pnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KELLY DOUGHERTY WASSEL PNP (NPI 1225303522) is an individual pediatrics provider in Saint Louis, Missouri, licensed in Missouri (2012006258) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225303522
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMRS. KELLY DOUGHERTY WASSELCredential: PNP
Location Address12360 MANCHESTER RD, STE 100Saint Louis, MO 63131-4302
Mailing Address12360 Manchester Rd, Ste 100Saint Louis, MO 63131-4302 · (314) 966-8500 · Fax (314) 996-4499
Phone(314) 966-8500
Fax(314) 996-4499
Sole ProprietorNo
Enumeration DateMarch 20, 2012
Last NPPES UpdateJune 13, 20193 updates tracked since enumeration
✔ NPI 1225303522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MO · 2012006258
12360 MANCHESTER RD, Saint Louis, MO 63131
Open in Google Maps ↗

Other Identifiers 1

Medicaid420020002MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kelly Dougherty Wassel Pnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63131 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JORDAN DAVIS DPT
Physical Therapist
12360 MANCHESTER RD
DES PERES, MO 63131
St. Louis County (314) 966-8855
YAMUNA MATHEW DDS PC
Clinic/Center (Dental)
12360 MANCHESTER RD, SUITE 201
SAINT LOUIS, MO 63131
St. Louis County (314) 394-0540
MTS-DES PERES, LLC
Physical Therapist
12360 MANCHESTER RD, SUITE 150
DES PERES, MO 63131
St. Louis County (636) 728-1777
CVPT-DES PERES, LLC
Physical Therapist
12360 MANCHESTER RD, SUITE 150
DES PERES, MO 63131
St. Louis County (636) 728-1777
MTS-DES PERES, LLC
Physical Therapist
12360 MANCHESTER RD, SUITE 150
DES PERES, MO 63131
St. Louis County (314) 966-2273
VARICOSE VEIN CENTER OF ST LOUIS, INC
Specialist
12360 MANCHESTER RD, STE 206
SAINT LOUIS, MO 63131
St. Louis County (314) 966-6100

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 Kelly Wassel's NPI number?

The NPI number for Kelly Wassel is 1225303522. It was assigned to this individual provider in the NPPES registry on March 20, 2012.

Where is Kelly Wassel located?

Kelly Wassel practices at 12360 Manchester Rd Ste 100, Saint Louis, MO 63131. The listed phone number is (314) 966-8500.

What is Kelly Wassel's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Kelly Wassel enrolled in Medicare?

Yes. Kelly Wassel is registered in the Medicare PECOS enrollment system.

What insurance does Kelly Wassel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 other insurers list Kelly Wassel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Wassel was last updated on June 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.