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AMANDA BERTHOLOMEY
NPI 1871103093
Nurse Practitioner - Family in Ballwin, MO

Active since August 03, 2020PECOS Enrolled
452 SOVEREIGN CT, BALLWIN, MO 63011(636) 222-8699 Get Directions Write a Review

NPPES record last updated: September 8, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 8, 2020, Aug 3, 2020 (2 updates tracked since 2020).

About Amanda Bertholomey NPPES

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

AMANDA BERTHOLOMEY (NPI 1871103093) is an individual family provider in Ballwin, Missouri, licensed in Missouri (2014018635) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871103093
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAMANDA BERTHOLOMEY
Location Address452 SOVEREIGN CTBallwin, MO 63011-4447
Mailing Address215 Cedar Mountain DrRobertsville, MO 63072-2018 · (314) 913-0306
Phone(636) 222-8699
Sole ProprietorNo
Enumeration DateAugust 3, 2020
Last NPPES UpdateSeptember 8, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2020
✔ NPI 1871103093 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
Licenses✔ Licensed in MO · 2014018635✔ Licensed in MO · 2020026219
452 SOVEREIGN CT, Ballwin, MO 63011
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Bertholomey 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Amanda Bertholomey reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mercy Aco Clinical Services Inc
5.2 mi
Neurology
15740 S OUTER 40 RD
Chesterfield, MO 63017
  • Reassigned Medicare billing, Missouri enrollment
  • 263 clinicians in this Medicare group
NPI 1063965093 (636) 237-4200
Mercy Health Northwest Arkansas Communities
252 mi
Multi-Specialty
1 MERCY WAY
Bella Vista, AR 72714
  • Reassigned Medicare billing, Arkansas enrollment
  • 472 clinicians in this Medicare group
NPI 1396173514 (479) 802-5555

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63011 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.

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 Amanda Bertholomey's NPI number?

The NPI number for Amanda Bertholomey is 1871103093. It was assigned to this individual provider in the NPPES registry on August 3, 2020.

Where is Amanda Bertholomey located?

Amanda Bertholomey practices at 452 Sovereign Ct, Ballwin, MO 63011. The listed phone number is (636) 222-8699.

What is Amanda Bertholomey's specialty?

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

Is Amanda Bertholomey enrolled in Medicare?

Yes. Amanda Bertholomey is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Amanda Bertholomey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Bertholomey reassigns Medicare benefits to 2 organizations: Mercy Aco Clinical Services Inc (Chesterfield, MO) and Mercy Health Northwest Arkansas Communities (Bella Vista, AR). Each 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 Amanda Bertholomey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Bertholomey accept?

Health plans from Anthem Blue Cross and Blue Shield list Amanda Bertholomey 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 Amanda Bertholomey was last updated on September 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.