MATTHEW DALE TIESKOETTER APRN
NPI 1508482506
Nurse Practitioner - Adult Health in Saint Louis, MO
About Matthew Dale Tieskoetter Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MATTHEW DALE TIESKOETTER APRN (NPI 1508482506) is an individual adult health provider in Saint Louis, Missouri, licensed in Missouri (2020003584) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, is affiliated with Ssm Health Depaul Hospital St Louis, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Matthew Dale Tieskoetter Aprn 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.
Medicare Billing Reassignment
Medicare enrollment records show Matthew Tieskoetter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fenton, MO 63026
- Reassigned Medicare billing, Missouri enrollment
- 697 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.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ssm Health Depaul Hospital St Louis
Acute Care Hospitals · Bridgeton, MOPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 63106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 63106
SAINT LOUIS, MO 63106
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 Matthew Tieskoetter's NPI number?
The NPI number for Matthew Tieskoetter is 1508482506. It was assigned to this individual provider in the NPPES registry on June 25, 2020.
Where is Matthew Tieskoetter located?
Matthew Tieskoetter practices at 915 N Grand Blvd, Saint Louis, MO 63106. The listed phone number is (314) 652-4100.
What is Matthew Tieskoetter's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Matthew Tieskoetter enrolled in Medicare?
Yes. Matthew Tieskoetter 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.
Which organization bills Medicare for Matthew Tieskoetter's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Tieskoetter reassigns Medicare benefits to Ssm Medical Group, Inc. (Fenton, 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 Matthew Tieskoetter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Matthew Tieskoetter accept?
Health plans from Oscar Insurance Company list Matthew Tieskoetter 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.
Is Matthew Tieskoetter affiliated with any hospitals?
According to CMS data, Matthew Tieskoetter is affiliated with Ssm Health Depaul Hospital St Louis.
When was this NPI record last updated?
The NPPES record for Matthew Tieskoetter was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days 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.
# Matthew Dale Tieskoetter, APRN · NPI 1508482506
Adult Health physician in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since June 25, 2020.
## Identity
- **NPI:** 1508482506 (Entity type: Individual)
- **Enumerated:** June 25, 2020
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 2020003584 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 915 N GRAND BLVD, Saint Louis, MO 63106-1621
- **Phone:** (314) 652-4100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Ssm Medical Group, Inc. (NPI 1700966207, Fenton, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** September 16, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1508482506) · Data from the CMS NPPES public registry.