REBECCA DEATHERAGE BUWALDA (APRNBC) – Nurse Practitioner, NPI 1366477226
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for REBECCA DEATHERAGE BUWALDA (APRNBC)
PO BOX 955534
SAINT LOUIS, MO 631952510
Phone:
Type: Mailing
12255 DE PAUL DR STE 600
BRIDGETON, MO 630442515
Phone: (314) 209-5100
Fax: (314) 291-9508
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: 2006-09-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20060921000290 | I | Nurse Practitioner | MO | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 202 | 161 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 77 | 68 | $0 |
| 99496 | Transitional care management services for problem of high complexity | 24 | 23 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 22 | 22 | $0 |
Insurance plans in this area (ZIP 63195)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MO | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO | |
| - | MO | |
| Interventional Pain Management, Anesthesiology | MO |
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