MS. MANDY ELIZABETH BETTENHAUSEN (AGNP) – Neurological Surgery Physician, NPI 1295254266
Neurological Surgery Physician
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NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for MS. MANDY ELIZABETH BETTENHAUSEN (AGNP)
660 S EUCLID AVE
MSC 8109-43-1160
SAINT LOUIS, MO 631101010
Phone: (314) 362-5298
Fax: (888) 824-2176
Type: Mailing
4901 FOREST PARK AVE
DIV SURG ACCS, STE 340
SAINT LOUIS, MO 631081495
Phone: (314) 362-5298
Fax: (888) 824-2176
Type: Location
140, Oakshire Drive West, Fairfield, Glen Carbon, Madison County, Illinois, 62034, United States
GLEN CARBON, IL 620348541
Phone: (314) 443-6929
Type: Mailing
660, South Euclid Avenue, Central West End, City of Saint Louis, Missouri, 63110, United States
SAINT LOUIS, MO 631101010
Phone: (314) 443-6929
Type: Location
5301 VETERANS MEMORIAL PKWY STE 105
SAINT PETERS, MO 633763429
Phone: (888) 828-8608
Fax: (314) 558-9017
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-11-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211025002057 | I | Nurse Practitioner | MO | TBD |
| I20211119001208 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KS | |
| N E U R O S U R G E R Y | MO | |
| Physician Assistant | IL | |
| Physician Assistant | OK | |
| N E U R O S U R G E R Y | MO | |
| - | MO | |
| Qualified Audiologist | MO | |
| Nurse Practitioner | MO | |
| U R O L O G Y | MO | |
| Otolaryngology, Plastic And Reconstructive Surgery | MO |
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