MISTY DAWN BIRNEY FNP
NPI 1578866596
Nurse Practitioner - Family in Saint Louis, MO

Active since December 14, 2010PECOS EnrolledAccepts Medicare Assignment
54.72/100
CMS Quality Rating
12660 LAMPLIGHTER SQR SHPPNG CTR, SUITE J, SAINT LOUIS, MO 63128(314) 394-1379(314) 394-1377 Get Directions Write a Review

NPPES record last updated: May 15, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Misty Dawn Birney Fnp NPPES

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

MISTY DAWN BIRNEY FNP (NPI 1578866596) is an individual family provider in Saint Louis, Missouri, licensed in Missouri (2010041400) and active in the NPI registry since December 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1578866596
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMISTY DAWN BIRNEYCredential: FNP
Location Address12660 LAMPLIGHTER SQR SHPPNG CTR, SUITE JSaint Louis, MO 63128-2761
Mailing Address12660 Lamplighter Sqr Shppng Ctr, JSaint Louis, MO 63128-2761 · (314) 394-1379 · Fax (314) 394-1377
Fax(314) 394-1377
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateDecember 14, 2010
Last NPPES UpdateMay 15, 2012
NPI 1578866596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in MO · 2010041400
12660 LAMPLIGHTER SQR SHPPNG CTR, Saint Louis, MO 63128

Other Identifiers 1

Other150770001MO · Medicare Ptan

Accepted Insurance

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

Misty Dawn Birney Fnp 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 ID3779639331
PECOS Enrollment IDI20110315000353
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.

Areas of Expertise CMS Part B claims 35

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
1,880 services19 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
168 services165 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
156 services36 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
116 services113 patients
Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635
This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.
99 services98 patients
Detection test by nucleic acid for multiple types influenza virus 87502
A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.
72 services72 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63128 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.

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.

54.72/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality47.43
Promoting Interoperability0
Improvement Activities40
Cost84.97

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier11 claims11 services$3.43 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

Prosthetic/Orthotic Supplier
12660 LAMPLIGHTER SQR SHPPNG CTR, SUITE J
SAINT LOUIS, MO 63128

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 Misty Birney's NPI number?

The NPI number for Misty Birney is 1578866596. It was assigned to this individual provider in the NPPES registry on December 14, 2010.

Where is Misty Birney located?

Misty Birney practices at 12660 Lamplighter Sqr Shppng Ctr Suite J, Saint Louis, MO 63128. The listed phone number is (314) 394-1379.

What is Misty Birney's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Misty Birney enrolled in Medicare?

Yes. Misty Birney 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.

What insurance does Misty Birney 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 Misty Birney 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 Misty Birney was last updated on May 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.