ROSE MATTLI (NP) – Nurse Practitioner, NPI 1760704290
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ROSE MATTLI (NP)
PO BOX 78429
SAINT LOUIS, MO 631788429
Phone: (314) 548-0265
Fax: (314) 548-6555
Type: Mailing
456 N NEW BALLAS RD STE 348
CREVE COEUR, MO 631416846
Phone: (314) 548-0265
Fax: (314) 548-6555
Type: Location
North Forty Drive, Town and Country, Saint Louis County, Missouri, 63131, United States
SUITE 205
ST. LOUIS, MO 631418657
Phone: (314) 720-0900
Fax: (314) 579-0180
Type: Mailing
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: 2010-06-11
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 |
|---|---|---|---|---|
| I20100611000794 | 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 |
|---|---|---|---|---|
| 90961 | Dialysis services, 2-3 physician visits per month (20 years or older) | 16 | 13 | $0 |
Insurance plans in this area (ZIP 63178)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MO | 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 63 | 44 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MO | |
| Internal Medicine | MO | |
| Physician Assistant | IL | |
| Nephrology, Internal Medicine | MO | |
| Internal Medicine, Nephrology | MO | |
| N E P H R O L O G Y | NJ | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| Physician Assistant | MO | |
| N E P H R O L O G Y | MO |
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