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KATHERINE MARIE LALLY PHYSICIAN ASSISTANT
NPI 1649239187
Physician Assistant in Saint Louis, MO

Active since March 22, 2006PECOS Enrolled
12639 OLD TESSON RD STE 115, SAINT LOUIS, MO 63128(314) 849-0311(314) 849-4423 Get Directions Write a Review

NPPES record last updated: August 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 11, 2019, Sep 16, 2019 (2 updates tracked since 2019).

About Katherine Marie Lally Physician Assistant NPPES

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

KATHERINE MARIE LALLY PHYSICIAN ASSISTANT (NPI 1649239187) is an individual physician assistant in Saint Louis, Missouri and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649239187
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKATHERINE MARIE LALLYCredential: PHYSICIAN ASSISTANT
Location Address12639 OLD TESSON RD STE 115Saint Louis, MO 63128-2786
Mailing Address845 N New Ballas Ct Fl 2Saint Louis, MO 63141-7134 · (314) 983-4700 · Fax (314) 567-7520
Phone(314) 849-0311
Fax(314) 849-4423
Sole ProprietorNo
Enumeration DateMarch 22, 2006
Last NPPES UpdateAugust 19, 20252 updates tracked since enumeration
NPPES CertifiedAugust 19, 2025
✔ NPI 1649239187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
12639 OLD TESSON RD STE 115, Saint Louis, MO 63128
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Other Names 1

Former Name (1)Ms. Katherine Marie Pudlowski Pa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, UnitedHealthcare.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)

Katherine Marie Lally Physician Assistant 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 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
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
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 10

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

NATHAN M FISHER D.O.
Orthopaedic Surgery (Hand Surgery)
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
SARAH E BRINKMANN NP
Nurse Practitioner
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
NICOLAS CLAY MARTIN D.P.M.
Podiatrist (Foot & Ankle Surgery)
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
MADDISSON ANN HASLETT NP
Nurse Practitioner (Gerontology)
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
ELLEN G. BARTON PA
Physician Assistant
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
DR. ASHLEY HAEGELE ALI M.D.
Orthopaedic Surgery
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
DR. CHRISTOPHER WARNER PALMER D.O.
Orthopaedic Surgery
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311
MR. CURTIS STEINLAGE PA
Physician Assistant
12639 OLD TESSON RD STE 115
SAINT LOUIS, MO 63128
St. Louis County (314) 849-0311

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 Katherine Lally's NPI number?

The NPI number for Katherine Lally is 1649239187. It was assigned to this individual provider in the NPPES registry on March 22, 2006. The provider is also known as Ms. Katherine Marie Pudlowski PA.

Where is Katherine Lally located?

Katherine Lally practices at 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128. The listed phone number is (314) 849-0311.

What is Katherine Lally's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Katherine Lally enrolled in Medicare?

Yes. Katherine Lally is registered in the Medicare PECOS enrollment system.

What insurance does Katherine Lally accept?

Health plans from Medica and UnitedHealthcare list Katherine Lally 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 Katherine Lally was last updated on August 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.