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MS. MANDY ELIZABETH BETTENHAUSEN AGNP
NPI 1295254266
Nurse Practitioner - Gerontology in Saint Louis, MO

Active since September 11, 2017PECOS EnrolledAccepts Medicare Assignment
4901 FOREST PARK AVE, DIV SURG ACCS, STE 340, SAINT LOUIS, MO 63108(314) 362-5298(888) 824-2176 Get Directions Write a Review

NPPES record last updated: August 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 23, 2023, Apr 11, 2023, May 18, 2022 and 3 more (6 updates tracked since 2017).

About Ms. Mandy Elizabeth Bettenhausen Agnp NPPES

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

MS. MANDY ELIZABETH BETTENHAUSEN AGNP (NPI 1295254266) is an individual gerontology provider in Saint Louis, Missouri, licensed in Missouri (2019008105) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1295254266
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameMS. MANDY ELIZABETH BETTENHAUSENCredential: AGNP
Location Address4901 FOREST PARK AVE, DIV SURG ACCS, STE 340Saint Louis, MO 63108-1495
Mailing Address660 S Euclid Ave, Msc 8109-43-1160Saint Louis, MO 63110-1010 · (314) 362-5298 · Fax (888) 824-2176
Phone(314) 362-5298
Fax(888) 824-2176
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateSeptember 11, 2017
Last NPPES UpdateAugust 23, 20236 updates tracked since enumeration
NPPES CertifiedMay 18, 2022
✔ NPI 1295254266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in MO · 2019008105
4901 FOREST PARK AVE, Saint Louis, MO 63108
Open in Google Maps ↗

Other Identifiers 1

Medicaid420103116MO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Mandy Elizabeth Bettenhausen Agnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294123212
PECOS Enrollment IDI20211025002057, I20211119001208
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 63108 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 20

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

DR. ERIN LEIGH DYER MD
General Practice
4901 FOREST PARK AVE, DIV IM GENERAL MED, STE 241
SAINT LOUIS, MO 63108
St. Louis City (314) 362-5060
DR. NICHOLE GALLEGOS ZEHNDER MD
General Practice
4901 FOREST PARK AVE, DIV IM GENERAL MED, STE 241
SAINT LOUIS, MO 63108
St. Louis City (314) 362-5060
MRS. NANCY J CIBULKA WHNP
Nurse Practitioner (Family)
4901 FOREST PARK AVE, STE 341
SAINT LOUIS, MO 63108
St. Louis City (314) 454-7882
DR. MARCIA J MCCABE PSYD
Psychologist
4901 FOREST PARK AVE, DEPT PSYCHIATRY, STE 441
SAINT LOUIS, MO 63108
St. Louis City (314) 286-1700
WASHINGTON UNIVERSITY
Clinic/Center (Multi-Specialty)
4901 FOREST PARK AVE
SAINT LOUIS, MO 63108
St. Louis City (314) 362-3937
DR. JING-WEI HUANG MD
Ophthalmology (Cornea and External Diseases Specialist)
4901 FOREST PARK AVE, DEPT OPHTHALMOLOGY, 6TH FL
SAINT LOUIS, MO 63108
St. Louis City (314) 362-3937
DR. JILLIAN MEI-LING LIU MD PHD
Ophthalmology (Cornea and External Diseases Specialist)
4901 FOREST PARK AVE, DEPT OPHTHALMOLOGY, 6TH FL
SAINT LOUIS, MO 63108
St. Louis City (314) 362-3937
DR. DAVID L EISENBERG MD
Obstetrics & Gynecology (Gynecology)
4901 FOREST PARK AVE, DIV OBGYN FAMILY PLANNING, STE 710
SAINT LOUIS, MO 63108
St. Louis City (314) 362-4211

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 Mandy Bettenhausen's NPI number?

The NPI number for Mandy Bettenhausen is 1295254266. It was assigned to this individual provider in the NPPES registry on September 11, 2017.

Where is Mandy Bettenhausen located?

Mandy Bettenhausen practices at 4901 Forest Park Ave Div Surg Accs, Ste 340, Saint Louis, MO 63108. The listed phone number is (314) 362-5298.

What is Mandy Bettenhausen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Mandy Bettenhausen enrolled in Medicare?

Yes. Mandy Bettenhausen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mandy Bettenhausen was last updated on August 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.