ANDREA E IVY N.P.
NPI 1649220104
Nurse Practitioner - Family in Bridgeton, MO

Q: What is Andrea Ivy's NPI number?

The NPI number for Andrea Ivy is 1649220104. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Q: What is Andrea Ivy's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Andrea Ivy was last updated on July 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since May 12, 2006PECOS EnrolledAccepts Medicare Assignment

12800 BOENKER LN, BRIDGETON, MO 63044(314) 551-0338(314) 551-0336 Get Directions Write a Review

NPPES record last updated: July 14, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Andrea E Ivy N.p. NPPES

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

ANDREA E IVY N.P. (NPI 1649220104) is an individual family provider in Bridgeton, Missouri, licensed in Missouri (137743) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1649220104

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameANDREA E IVYCredential: N.P.

Location Address12800 BOENKER LNBridgeton, MO 63044-2438

Mailing Address12800 Boenker LnBridgeton, MO 63044-2438 · (314) 551-0338 · Fax (314) 551-0336

Phone(314) 551-0338

Fax(314) 551-0336

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateMay 12, 2006

Last NPPES UpdateJuly 14, 2014

✔ NPI 1649220104 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 · 137743

12800 BOENKER LN, Bridgeton, MO 63044

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Other Identifiers 6

Medicare UPINQ27494MO

Medicaid429398209MO

Medicare PIN000013853MO

Medicare PIN822223853MO

Medicare PINS39000003MO

Medicare PINMA1084002MO

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

Andrea E Ivy N.p. 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 ID7618930090

PECOS Enrollment IDI20041106000029

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 63044 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 9

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

PHYLICIA LITTLE FNP-BC

Nurse Practitioner (Family)