MATTHEW CHARLES – Psychiatric/Mental Health Nurse Practitioner, NPI 1770913089

MATTHEW CHARLES is a healthcare provider. based in Saint louis, Missouri. specializing in NURSE PRACTITIONER. They hold a License No. 2013037719 (MO). The NPI Number for MATTHEW CHARLES is 1770913089

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW CHARLES
NPI
1770913089
Phone
(314) 525-4429
Address
10004 KENNERLY RD
Enumeration Date
22 November 2013
Last Update Date
14 March 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6186887020
Graduation Year
2013 (13 years ago)
PAC ID
4486884129
Group Practice PAC ID
8729412689
Professional Enrollment ID
I20220422000994
Address ID
IL622082074FA303XXPKWY301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:12State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for MATTHEW CHARLES

  • 10004 KENNERLY RD

    STE 364B

    SAINT LOUIS, MO 631282141

    Phone: (314) 525-4429

    Fax: (314) 525-7260

    Mailing address matches the actual address.

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: 2022-12-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140225002284INurse PractitionerMOTBD
I20220422000994INurse PractitionerILTBD
I20221207001713INurse PractitionerTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G2212Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or45615$0
99215Established patient office or other outpatient visit, 40-54 minutes11415$0
View full utilization report →

Insurance plans in this area (ZIP 63128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729412689View full group profile
NameSpecialtyState
P S Y C H I A T R YMO
Nurse PractitionerIL

Reviews

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Frequently asked questions

What unique ID ties claims to MATTHEW CHARLES?
NPI 1770913089 is assigned to MATTHEW CHARLES under the national enumeration system.
Is MATTHEW CHARLES's NPI currently valid?
The extract we use shows MATTHEW CHARLES as active.
Can you summarize MATTHEW CHARLES's specialty in plain language?
Clinically, the directory lists MATTHEW CHARLES with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does MATTHEW CHARLES practice in Missouri?
You will see Saint Louis, Missouri on file for MATTHEW CHARLES alongside any extra practice locations.
What if Saint Louis, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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