LISA PORTHOUSE CNM
NPI 1750653697
Advanced Practice Midwife in Saint Louis, MO

NPI Status: Active since February 08, 2012

Contact Information

621 S NEW BALLAS RD
SUITE 2009 B
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 251-6000
Fax: (314) 251-4376

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Advanced Practice Midwife
Accepts Insurance
PECOS Enrolled

About LISA PORTHOUSE

This page provides the complete NPI Profile along with additional information for Lisa Porthouse, a provider established in Saint Louis, Missouri with a medical specialization in Advanced Practice Midwife. The healthcare provider is registered in the NPI registry with number 1750653697 assigned on February 2012. The practitioner's primary taxonomy code is 367A00000X with license number 113826 (MO). The provider is registered as an individual and her NPI record was last updated 12 years ago.

NPI: 1750653697
Provider Name: LISA PORTHOUSE CNM
Gender: Female
Entity Type: Individual
Location Address: 621 S NEW BALLAS RD SUITE 2009 B SAINT LOUIS, MO 63141
Location Phone: (314) 251-6000
Location Fax: (314) 251-4376
Mailing Address: 621 S NEW BALLAS RD SUITE 2009 B SAINT LOUIS, MO 63141
Mailing Phone: (314) 251-6000
Mailing Fax: (314) 251-4376
Is Sole Proprietor?: Yes
Enumeration Date: 02-08-2012
Last Update Date: 06-24-2013
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Advanced Practice Midwife
Taxonomy Code: 367A00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: 113826
License State: MO
Taxonomy Description: Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Aetna CVS Health

Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care - EPO
Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
Bronze S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
Gold S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
Silver 5 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
Silver S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
Silver S: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - EPO

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Bronze Pathway 9200 (+ Incentives) - EPO
Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO

Medica

Balance by Medica Bronze $0 Copay PCP Visits - EPO
Balance by Medica Bronze $0 Copay PCP Visits - PPO
Balance by Medica Bronze Premier - EPO
Balance by Medica Bronze Premier - PPO
Balance by Medica Catastrophic - EPO
Balance by Medica Catastrophic - PPO
Balance by Medica Expanded Bronze Standard - EPO
Balance by Medica Expanded Bronze Standard - PPO
Balance by Medica Gold $0 Copay PCP Visits - EPO
Balance by Medica Gold $0 Copay PCP Visits - PPO
Balance by Medica Gold Share - EPO
Balance by Medica Gold Share - PPO
Balance by Medica Gold Standard - EPO
Balance by Medica Gold Standard - PPO
Balance by Medica Silver $0 Copay PCP Visits - EPO
Balance by Medica Silver $0 Copay PCP Visits - PPO
Balance by Medica Silver Share - EPO
Balance by Medica Silver Share - PPO
Balance by Medica Silver Standard - EPO
Balance by Medica Silver Standard - PPO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
UHC Bronze Standard (No Referrals) - EPO
UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
UHC Gold Standard (No Referrals) - EPO
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
UHC Silver Standard (No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Lisa Porthouse is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 63141 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $86.32
Minimum New Patient Price $55.65
Maximum New Patient Price $169.38

Average New Patient Copayment $21.58
Minimum New Patient Copayment $13.91
Maximum New Patient Copayment $42.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $69.5
Minimum Established Patient Price $17.76
Maximum Established Patient Price $137.92

Average Established Patient Copayment $17.37
Minimum Established Patient Copayment $4.44
Maximum Established Patient Copayment $34.48

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	5	0	6	5	3	6	9	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	10	0	12	5	6	6	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 2 + 5 + 6 + 6 + 1 + 8 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 7									7

The NPI number 1750653697 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. ROBERT J BACKER MD

Specialist

621 S NEW BALLAS RD
STE 297A
SAINT LOUIS, MO
ZIP 63141

About LISA PORTHOUSE

Location Map

Specialty - Primary Taxonomy

Advanced Practice Midwife

Insurance Plans Accepted

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): No

Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for LISA PORTHOUSE CNM

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions